Self Monitoring and Heart Failure

If you have heart failure (HF) that has been treated with medications, surgical procedures, or medical devices, chances are you have been given instructions on how to manage your care at home. HF is a common reason for hospitalization, hospital readmission, and death worldwide.¹

Heart failure is a chronic condition that requires long-term lifestyle management. This includes:^1-3

• Diet and weight management
• Fluid intake and blood pressure monitoring
• A program for physical activity
• A strict medication regimen

Many people who manage their heart failure condition well do a good job of routinely monitoring their condition. Self-reported information like changes in weight can lead to early intervention in cases of early decompensated HF. Knowing what information to monitor and what kinds of changes to note are important educational tools that should be shared between you and your healthcare team. Good self-monitoring can benefit your overall health and enhance quality of life.^1-3

Self-monitoring at home

The American Heart Association recommends regular monitoring for everyone with high blood pressure and other cardiac conditions. This monitoring provides information that can improve your doctor's understanding of whether your HF treatments are effective.⁴

Also called home monitoring, tracking your blood pressure, medications, weight, fluid intake, and other measurements of treatment compliance can help your doctor manage your overall health and response to treatment.⁴

What should I monitor?

• Worsening HF symptoms
• Medication tracking
• Blood pressure
• Exercise
• Daily weight
• Diet
• Sodium, fat, and fluid intake
• Breathing difficulty
• Smoking
• Changes in mental health

Monitoring can be complex. HF treatment can involve major lifestyle changes that require adjustments to many aspects of life. For example, people with heart failure often take multiple medications several times a day. Developing a tracking system to be sure you take all of your medications as prescribed can be a helpful reminder not to skip a dose. For example, some people use pill boxes, phone alarms, medication calendars, or a combination of all three. Noting any changes to your diet can be helpful especially if you are instructed to restrict fluids and salt intake.^1-3

One tip is to monitor your daily weight. Weighing yourself at the same time each day wearing the same clothes and on the same scale can help you evaluate any sudden changes due to fluid retention. For example, try weighing yourself first thing every morning after you go to the bathroom.^2,3

Just like weighing yourself, taking blood pressure readings at the same time each day is another important measurement to monitor. Most doctors recommend an automatic, cuff-style, bicep (upper-arm) monitor. Use the monitor to take your blood pressure twice a day or as directed by your healthcare team. Take 2 or 3 readings to be sure you are doing it correctly each time. Log your results and follow your doctor’s instructions about what to do if your blood pressure changes.^2,4

Reporting these and other changes to your healthcare team may help identify early warning signs of heart failure decline. Treating heart failure is most effective when there is collaboration and communication between patients and providers. Treatment decisions may be modified based in part by self-monitoring.^1,2

How should I monitor

People choose different ways to collect and report their information. Some people journal, either keeping a paper or online narrative of the information they are tracking. There are medication checklists, symptom trackers, and almost everything you need is available on paper and in an app. Whatever method you choose needs to be comfortable for you or your caregivers.²

When should I call a doctor?

Although keeping a daily record can feel time-consuming and even annoying, tracking your routine and your results can help you notice small but meaningful changes. When you monitor how well you are sticking to your diet and exercise recommendations, medications, and blood pressure checks, you are more likely to actively engage with your healthcare team.

Always bring your records to your medical visits. The information you share with your providers can offer a more complete picture of how you are doing from day to day. This can help them evaluate how well your medicines are working and if they need to be adjusted. Remember, only your healthcare team can make changes to your treatment plan. Even if you feel well or your numbers are good, don’t stop taking your medications, change your diet, or return to habits like smoking or drinking too much alcohol.^2,3

The importance of teamwork

Good heart failure care often requires complex treatment regimens. Self-monitoring can be complex, and it can be hard to stick to your treatment and monitoring plan. If you have questions or concerns, talk to your healthcare team. With education and professional support, you can achieve significant benefits from good self-care, monitoring, and reporting.^2,3