Lifestyle Changes and Heart Failure

Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Heart failure (HF) develops when the heart is no longer pumping well enough to meet the demands of the body.1-2 Common symptoms include fatigue, shortness of breath and exercise intolerance, which is the reduced ability to perform physical activities that require significant movement or exertion.

The American Heart Association (AHA) has established Diet and Lifestyle Recommendations that can help better manage HF, slow the progression, and possibly prevent other medical and cardiac complications.1-3 Because small changes can make a difference, it is important to get started, even if the change is gradual.2-3

The AHA website offers recommendations about diet, exercise and other healthy habits that can improve everyday life. Important lifestyle changes include regular exercise, a heart-healthy diet, and good stress management skills.2 Lifestyle changes are good for the whole family. Eating right and exercising together can benefit everyone and have a lifelong impact even on those who do not have heart failure.

Dietary restrictions

For patients with heart failure, following a low sodium diet is key to helping manage symptoms. Salt causes fluid retention which makes it harder for the heart to work. It is recommended that people with heart failure consume only 2-3 grams of sodium per day. Ask your healthcare provider for your restriction. It is also important to monitor your fluid intake. While drinking water is healthy and encouraged, drinking too much can worsen symptoms. It is typical for someone with heart failure to have a 2-liter fluid restriction. Ask your healthcare provider how much fluid you should be drinking.

Heart-healthy eating

If you have heart disease it is never too soon to begin eating a heart-healthy diet. The AHA offers a guide to a healthy diet as part of the lifestyle recommendations. You can make gradual changes towards eating a healthy diet which includes:1-3

  • Eating more fruits and vegetables
  • Eating whole grains, nuts, and legumes
  • Reduce bad fats by not eating fried or processed foods
  • Eating low-fat proteins like poultry and fish
  • Lower your salt, sugar, red meat, alcohol and white starch intake
  • Avoid or limit caffeine and alcohol

The benefits of a heart-healthy diet include lowering bad cholesterol, decreasing inflammation, and achieving weight loss or maintaining a healthy weight.2 Controlling portion size, making good food choices, and not consuming more calories than you burn can help you eat according to a heart-healthy lifestyle. Your healthcare team can offer guidance on personal diet plans, restrictions or objectives based on your individual circumstances.1-2 Fluid intake, in particular, may be recommended if you have congestive heart failure.2-3


It is recommended to get 150 minutes of moderate-intensity activity or 75 minutes of high-intensity activity per week, in addition to two sessions of strength training per week is indicated for good heart health.3 But many with heart failure have become inactive due to debilitating symptoms or other illnesses making exercise difficult. For good heart health, it is important to become more active on a gradual basis. Your healthcare team can guide you on what exercise plan is safe and appropriate for you.1 Regular exercise can ease symptoms and help extend life. Exercise is beneficial for reducing blood pressure, improving or maintaining cholesterol levels, controlling weight and helping manage diabetes and other comorbid medical conditions.1

Stress management

When under stress the body releases hormones to help respond to stressors. This causes the heart to speed up creating a racing feeling, rapid breathing, and a rush of energy. When stress occurs frequently or is prolonged it can produce negative health effects.2,4 Stress can manifest as psychological or physiological symptoms. It can weaken the immune system or exacerbate an existing health problem. Stress can impact certain behaviors that increase the risk for heart disease that can raise blood pressure, contribute to depression, and other conditions that may make you feel socially isolated or cause you to stay home and be sedentary.2-4

Reactions to stress may result in some people indulging in certain behaviors like smoking, overeating, and drinking too much alcohol.1-4 If you are already living with heart failure, this can cause your condition to worsen. The impact of stress on behavior can increase blood pressure and damage blood vessels, essential to good circulation and overall mental and physical functioning.2,3

Stress management techniques are important components of a heart-healthy lifestyle. Relaxation, getting adequate rest, finding joy and being active are but a few of the steps you can take to manage your stress and your blood pressure. Blood pressure monitoring, at home and at work, while exercising and in stressful situations, can help you learn more about how certain activities affect your heart health.1-2

Developing good lifestyle habits takes time and requires commitment. Getting support from friends and family, your health care team and others can make the process easier. Heart-healthy lifestyle changes can improve the quality of life for the whole family.2

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