Int J Heart Fail.  2023 Jan;5(1):21-33. 10.36628/ijhf.2022.0032.

Lifestyle Modification in Heart Failure Management: Are We Using EvidenceBased Recommendations in Real World Practice?

Affiliations
  • 1Heart Failure Unit, Internal Medicine Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
  • 2Center for Biomedical Network Research in Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
  • 3Division of Cardiology, Department of Internal Medicine, Anam Hospital, Korea University Medicine, Seoul, Korea
  • 4Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea

Abstract

The heart failure (HF) guideline’s purpose is to assist medical professionals while treating patients with HF in accordance with the best current research. Many cases of HF are both, avoidable and treatable thanks to scientific trials. Management is, therefore, based on lifestyle changes, also called non-pharmacological treatment. These, based on lifestyle changes, should be recommended in every patient at risk for HF or with diagnosed of HF, but evidence in itself is scarce. DASH Diet could be clearly beneficial while Mediterranean diet doesn't have enough evidence at the present moment. Smoking should be stopped, and excessive amounts of alcohol drinking avoided, but there is no clinical trial nor registry performed on these aspects. A moderate salt restriction is better than a strict reduction. Exercise and cardiac rehabilitation are beneficial but there are no clear recommendations about type, duration, etc. Most of the evidence that we have in HF patients with obesity is contradictory. Finally, due to the high number of aged frail patients in HF lifestyle changes should be individualized, but again available data is scant. Therefore, due to the lack of current evidence, these gaps need to be considered and need new efforts on investigation in the next future.

Keyword

Sodium; Diet therapy; Heart failure; Exercise
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