Heart failure is most often a chronic condition that occurs when your heart can no longer pump effectively. Blood and oxygen needs of the body are not met. This can lead to symptoms throughout the body, including shortness of breath, fatigue and swelling in the legs, feet and abdomen.
Heart failure can usually be treated successfully. Making lifestyle changes and following a drug plan can often help you live longer and improve your quality of life.
Lifestyle changes include basic heart-healthy habits such as quitting smoking, losing excess weight, avoiding alcohol and eating healthy low-fat and low-salt foods. Regular, modest exercise (under your doctor's guidance) can also help. But, even with lifestyle changes, you will probably have to take several medications.
Medications for heart failure
Some key drugs used to treat heart failure include:
Angiotensin converting enzyme (ACE) inhibitors. These include captopril, lisinopril and enalapril. ACE inhibitors prevent the formation of angiotensin, a substance that constricts or tightens the arteries. In this way, ACE inhibitors help relax the blood vessels and lower the blood pressure. These drugs also help the heart muscle itself. When you take ACE inhibitors, the heart does not have to work as hard to pump blood through the arteries. One side effect of ACE inhibitors may be a chronic cough.
Angiotensin II receptor blockers (ARBs). These include losartan, valsartan and candesartan.ARBs also relax blood vessels and lower blood pressure. While ACE inhibitors prevent production of angiotensin, ARBs block it from working. ARBs may be used if side effects of ACE inhibitors, especially coughing, are bothersome.
Vasodilators (such as nitroglycerine, nesiritide and hydralazine). These medications help relax and widen blood vessels and improve blood flow. Nitroglycerine is also used to reduce or prevent chest pain.
Beta-blockers (such as carvedilol and metoprolol). These drugs slow the heart rate and lower blood pressure. In heart failure, the heart may beat faster to try to compensate for weak muscle. Beta-blockers are usually started at a low dose and are not recommended for people with severe heart failure.
Diuretics (such as furosemide, spironolactone, and hydrochlorthiazide).These are also called "water pills." They reduce the amount of fluid in the body, which helps cut the heart's workload. Spironolactone (Aldactone) is a specialized type of diuretic that has other properties that seem to help heart failure. It may be used for people with severe heart failure.
Digitalis (digoxin or digitoxin ). This drug increases the force of the heart's contractions, which helps improve circulation. It needs to be closely monitored and adjusted as needed to keep the levels safe and effective.
Other treatments for heart failure
Surgery to improve blood flow to the heart muscle (such as coronary artery bypass surgery or CABG) or surgery to repair or replace diseased heart valves can improve heart failure for some. People with severe or end-stage heart failure may sometimes be considered for a heart transplant. There is limited availability of hearts, though, and the wait may be too long.
Biventricular pacemakers can help those who have certain abnormal heart rhythms caused by damaged and weakened heart muscle. Abnormal or erratic heart rhythms can make heart failure worse. This device paces both of the heart's lower chambers for more efficient pumping.
Left ventricular assist device (LVAD) is a newer option for improving heart failure. But it's only for short-term situations, such as while you are waiting for a transplant heart to become available. An LVAD is a small, artificial pump that is implanted in the abdomen and connected to the heart to help it pump. Doctors are also researching this as a possible long term treatment.
Created on 06/28/1999
Updated on 08/29/2011
- American Heart Association. Medications commonly used to treat heart failure.
- Hunt SA, Abraham WT, Chin MG, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult. Circulation. 2005;112:1825-1852.