JAMA CARDIOLOGY PATIENT PAGE

Prevention of Heart Failure

Heart failure is a condition leading to symptoms such as shortness of breath, swelling of the legs,
fatigue, and inability to exercise.

The root cause of heart failure is dysfunction of the heart muscle. Some cancer chemotherapies can weaken the heart and lead
This dysfunction occurs in 1 of 2 ways: a weakening of the muscle, to heart failure. If you are undergoing chemotherapy, ask your doc-
resulting in a decrease in the heart’s pumping capacity, or an in- tor whether your heart function needs to be monitored.
creased stiffness of the heart muscle so that the heart cannot relax
properly while the heart fills with blood. How to Prevent Heart Failure
Fortunately, there are many avenues for preventing the onset of 1 in 5 adults developp
heartfailureincludingbothhealthylifestylebehaviorsandpropermedi- HEART FAILURE
cal treatment for conditions that predispose one to heart failure.
Regular physical activity (exercising ⱖ5 d/wk) and maintaining Ways to reduce risk
a health body weight are key ingredients to preventing heart fail- of developing heart failure
Lifestyle factors Medical conditions
ure. Other healthy behaviors also lower the risk of developing heart
failure: not smoking, eating fruits and vegetables (4 servings/d), and Regular Treat high
physical blood
moderate alcohol intake (1 drink/d). On the other hand, heavy alco- activity pressure
hol/binge drinking and cocaine/amphetamine abuse can lead to heart
failure and other health problems and thus should be avoided. Lastly,
Healthy Control
eating fish and drinking a moderate amount of coffee (ⱕ 4 cups/d) weight diabetes
have also been linked to less heart failure.
Hypertension (high blood pressure) is a major risk factor for the
development of heart failure. Blood pressure lowering in some indi- Maintain
viduals known to be at higher risk for heart disease to an optimal level No healthy
smoking cholesterol
of approximately 120/80 mm Hg can significantly reduce this risk. Spe- levels
cific medicines that lower blood pressure and are also effective in low-
ering heart failure risk include diuretics, angiotensin-converting Take heart
Healthy protective
enzyme inhibitors, angiotensin receptor blockers, and β-blockers. eating medications
Type 2 diabetes (high blood glucose) predisposes one to the de- as prescribed
velopment of heart failure, and treatment of diabetes to lower blood
glucose with diet, exercise, and certain antidiabetic medications
under the care of your physician can significantly lower your risk. FOR MORE INFORMATION
Cholesterol buildup in the arteries that supply blood to the heart, National Heart Lung and Blood Institute
also known as atherosclerotic coronary artery disease, can result in https://www.nhlbi.nih.gov/health/health-topics/topics/hf
heart attacks that damage and weaken the heart muscle. This is an- /prevention
other leading cause of heart failure. Under the care of a cardiologist, American Heart Association
treatment of risk factors can effectively reduce risk of heart attacks
http://www.heart.org/HEARTORG/Conditions/HeartFailure
and heart failure with drugs such as statins (cholesterol-lowering medi- /Heart-Failure_UCM_002019_SubHomePage.jsp
cines) and aspirin. Diet and exercise are important as well.
http://www.heart.org/HEARTORG/Conditions/My-Life-Check—Lifes
Genetics also play a role in many forms of heart failure. If you -Simple-7_UCM_471453_Article.jsp#.V5zUKnzrv3g
have a family member with heart failure, you should ask your doc-
tor to consider heart failure screening and genetic testing.

Authors: Tamara B. Horwich, MD, MS; Gregg C. Fonarow, MD
Published Online: December 7, 2016. doi:10.1001/jamacardio.2016.3394
Conflict of Interest Disclosures: All authors have completed and submitted the
ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Horwich receives
research grants from the National Institutes of Health. Dr Fonarow receives research
grants from the National Institutes of Health and is a consultant for Amgen, Novartis,
Medtronic, and St Jude. No other disclosures were reported.
Sources: Yancy CW, Jessup M, Bozkurt B, et al; American College of Cardiology
Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/
AHA guideline for the management of heart failure: a report of the American College of
Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.
J Am Coll Cardiol. 2013;62(16):e147-e239.http://www.ncbi.nlm.nih.gov/entrez/query
.fcgi?cmd=Retrieve&db=PubMed&list_uids=23747642&dopt=Abstract
Larsson SC, Tektonidis TG, Gigante B, Åkesson A, Wolk A. Healthy lifestyle and risk of
heart failure: results from 2 prospective cohort studies. Circ Heart Fail.
2016;9(4):e002855.
Section Editor: Mintu Turakhia, MD, MAS.
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