Manage Heart Failure With Lifestyle
Having heart failure can leave you feeling out control. But through diet, exercise, and self-monitoring you can make a real difference in both your symptoms and your outlook.
Given the weakness that many people with heart failure experience, which can even make moving across a room exhausting, the idea of exercise may seem ludicrous. "We used to tell people with heart failure to just rest," says Bennett, "but now we know that in many conditions, you're probably healthier if you get a little exercise."
Indeed, a recent statement from the American Heart Association, based on a review of the medical literature, indicated that exercise seems to be beneficial for heart failure patients, even for those with advanced forms of the disease.
Of course, anyone with heart failure absolutely must check with a doctor before undertaking an exercise plan. But all sorts of aerobic activity -- walking, biking, and swimming, for instance -- appear to be beneficial in many cases. Exercise improves the condition of blood vessels and lowers the levels of harmful hormones in the bloodstream.
Exercise also makes people feel better, it improves heart-failure symptoms, and it makes it easier to do normal, everyday physical tasks that can become difficult in advanced stages of heart failure. The American Heart Association recommends 20 to 30 minutes of aerobic activity three to five days a week; people with advanced heart failure may need longer warm-up periods.
However, Bennett cautions we still need more data from large studies before we can be sure of the types and amounts of exercise to recommend for heart failure. She also points out the benefits of exercise have been shown only in patients who were medically stable, so it may not be safe for everyone.
"I think that exercise may play an important role in treatment," says Bertram Pitt, MD, internal medicine professor at the University of Michigan. Although he cautions that we don't know all of the answers yet, he is optimistic about a new study of exercise in heart failure patients that has just begun.
Getting a good night's sleep is, not surprisingly, good for people with heart failure -- just as it is for anybody. But for people who sleep less than eight hours a night, a recent study suggested that the less you sleep, the higher your risk of developing heart disease. The reasons aren't entirely clear, but it is known that during sleep, the pulse, blood pressure, and levels of certain hormones are lowered, allowing the body to rest.
Unfortunately, some medications used to treat heart failure may make it hard to sleep soundly. For instance, people taking diuretics often wake up several times a night to go to the bathroom; talk to your doctor about scheduling your doses to help lessen or prevent this problem.
A particular concern for people with heart failure is a connection between this heart problem and sleep apnea, a disorder in which a person temporarily stops breathing for ten seconds or more while asleep. Sleep apnea -- usually caused by a physical obstruction in the airway -- is seen in about a third of people with heart failure. Treatment involves surgery or wearing a breathing mask during the night. A recent study showed that treatment with the breathing mask -- called CPAP -- improved symptoms of both heart failure and sleep apnea.