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JAMA Cardiology Patient Page
January 2017

Prevention of Heart Failure

JAMA Cardiol. 2017;2(1):116. doi:10.1001/jamacardio.2016.3394

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. This dysfunction occurs in 1 of 2 ways: a weakening of the muscle, resulting in a decrease in the heart’s pumping capacity, or an increased stiffness of the heart muscle so that the heart cannot relax properly while the heart fills with blood.

Fortunately, there are many avenues for preventing the onset of heart failure including both healthy lifestyle behaviors and proper medical treatment for conditions that predispose one to heart failure.

Regular physical activity (exercising ≥5 d/wk) and maintaining a health body weight are key ingredients to preventing heart failure. Other healthy behaviors also lower the risk of developing heart failure: not smoking, eating fruits and vegetables (4 servings/d), and moderate alcohol intake (1 drink/d). On the other hand, heavy alcohol/binge drinking and cocaine/amphetamine abuse can lead to heart failure and other health problems and thus should be avoided. Lastly, eating fish and drinking a moderate amount of coffee (≤ 4 cups/d) 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 individuals known to be at higher risk for heart disease to an optimal level of approximately 120/80 mm Hg can significantly reduce this risk. Specific medicines that lower blood pressure and are also effective in lowering heart failure risk include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers.

Type 2 diabetes (high blood glucose) predisposes one to the development 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.

Cholesterol buildup in the arteries that supply blood to the heart, also known as atherosclerotic coronary artery disease, can result in heart attacks that damage and weaken the heart muscle. This is another leading cause of heart failure. Under the care of a cardiologist, treatment of risk factors can effectively reduce risk of heart attacks and heart failure with drugs such as statins (cholesterol-lowering medicines) and aspirin. Diet and exercise are important as well.

Genetics also play a role in many forms of heart failure. If you have a family member with heart failure, you should ask your doctor to consider heart failure screening and genetic testing.

Some cancer chemotherapies can weaken the heart and lead to heart failure. If you are undergoing chemotherapy, ask your doctor whether your heart function needs to be monitored.

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Section Editor: Mintu Turakhia, MD, MAS.
The JAMA Cardiology Patient Page is a public service of JAMA Cardiology. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Cardiology suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call (312) 464-0776.
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Article Information

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.

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