Advice and resources : Living with heart failure

Heart failure means your heart needs some support to help it work better, and this could mean monitoring your health carefully and making some lifestyle changes.

• Read more about what heart failure is

Daily checklist

If you have a confirmed diagnosis of heart failure, you need to be doing all of the following every day.

Watch out for rapid weight change

Record your weight daily. If your weight increases or decreases by two kilograms (4-5lb) within three days, please contact your Heart Function Nurse.

Maintain a healthy diet

Eat balanced meals that are low in salt (sodium) and manage your fluid intake as advised by your Heart Function Nurse. You should also limit the amount of alcohol you drink (or stop drinking alcohol entirely if this is what you have been advised).

Find advice on the NHS UK website:

• Eating a balanced diet
• Cutting down alcohol

Exercise regularly

Physical activity is good for your heart, so try to at least walk for 10 minutes a day or as advised by your Heart Function Nurse.

Check for warning signs

Contact your Heart Function Nurse if you have:

• swelling in your lower body, including your legs, ankles, and abdomen
• shortness of breath
• a worsening cough
• trouble sleeping (difficulty lying flat)
• loss of appetite
• dizziness
• confusion
• sudden feelings of sadness or depression

If you experience any chest pain that is not relieved by three sprays of glyceryl trinitrate (GTN), contact 999.

Sick day rules

You may have been advised to pause certain medicines if you’re feeling unwell (unless it’s only minor).

Feeling unwell includes:

• being sick (vomiting)
• loose or more frequent pooing (diarrhoea)
• having a fever (body temperature at 38C or above), which might include sweats or shaking

It's very important that you restart your medicine once you have recovered. This would normally be after 24 to 48 hours of eating and drinking normally. When you restart your medicine, just take them as normal.

Do not take extra for the doses you have missed.

During your illness, remember to keep yourself hydrated and try to keep up your daily checklist, including weighing yourself.

Contact your Heart Function nurse if:

• you’re not sure whether to stop or restart taking medication
• you’ve been ill for more than two days

Types of medication

If you have heart failure, it’s likely you need to take two or three different medicines. The following describes some that you might be prescribed and what they do.

Angiotensin-converting enzyme (ACE) inhibitors

Purpose: Makes it easier for your heart to pump blood around the body by relaxing and opening up your blood vessels.

Names (including brand names): ACE inhibitors end in ‘pril’, and include ramipril (Tritace), captopril, enalapril (Innovace), lisinopril (Zestril), and perindopril (Coversyl Arginine).

Angiotensin-2 receptor blockers (ARBs)

Purpose: Relax blood vessels and reduce blood pressure (alternative to ACE inhibitors).

Names (including brand names): ARBs end in ‘sartan’, and include candesartan (Amias), losartan (Cozaar), telmisartan, and valsartan (Diovan).

Angiotensin Receptor-Neprilysin Inhibitor (ARNI)

Purpose: Combines an ARB and a neprilysin inhibitor, which also helps relax blood vessels.

Names (including brand names): Sacubitril Valsartan (Entresto).

Beta blockers

Purpose: Slows your heart down and protects it from hormones like adrenaline that trigger your body’s ‘fight or flight’ response.

Names: Most beta blockers end in ‘lol’, and that includes bisoprolol, carvedilol, and nebivolol.

Diuretics

Purpose: Increase urine output (which is why they are often referred to as ‘water pills’) and help lower blood pressure and reduce fluid around the heart.

Names (including brand names): Diuretics usually end in ‘ide’ and include furosemide (Frusol/ Diuresal), bumetanide, bendroflumethiazide (Aprinox), and metolazone (Xaqua®).

Mineralocorticoid receptor antagonists (MRAs)

Purpose: Similar to diuretics (increase urine output, lower blood pressure, and reduce fluid around the heart) but doesn’t reduce potassium levels.

Names (including brand names): Usually ending in ‘one’, including spironolactone (Aldactone) and eplerenone (Inspra).

SGLT2 inhibitors

Purpose: Help lower blood sugar levels.

Names (including brand names): Medicine names ending in ‘gliflozin’, including empagliflozin (Jardiance) and dapagliflozin (Forxiga).