Heart Failure is a chronic medical condition, that is, one that usually requires life-long treatment. Many people with heart failure also have other chronic medical conditions. Other chronic medical conditions may require that you take medicines or make lifestyle changes in addition to taking the medicines prescribed as part of your heart failure treatment plan. To help your doctors and nurses better manage your care, be sure to tell them about all of your chronic medical conditions including any medicines you are taking to treat these other conditions. Trying to manage several medical conditions at the same time may be confusing.
This module will provide information on:
- Other chronic medical conditions commonly experienced by people with heart failure.
- The impact of these other chronic medical conditions on heart failure and its treatment.
- Lifestyle changes that may be required to manage your overall health when dealing with more than one chronic medical condition.
It will help you:
- Understand how some common chronic medical conditions can impact your heart failure treatment plan.
- Learn about the medicines and lifestyle changes used to treat these other chronic medical conditions.
- Learn how to better manage all of your chronic medical conditions including heart failure.
People with heart failure can have other medical conditions and/or illnesses. Managing these with your heart failure can be difficult, so it is important that everyone on your health care team is aware of your medications, conditions, and illnesses. It is important to keep a record or list of you acute and chronic problems, as well as a list of medicines you take, with you for your health care team to review. Try to use the same pharmacy for all your prescription medicines, so your community pharmacist can inform you of interactions, risks, and benefits of the medicines. Never stop taking any medicines without speaking to your prescribing doctor first.
The most common chronic conditions that people with heart failure have are:
- Diabetes.
- Lung disease.
- High blood pressure.
- High cholesterol.
- Decreased kidney function.
- Arthritis, and muscle and joint pain
About one-third of individuals with heart failure also have diabetes. Having diabetes and heart failure can worsen your heart health if the diabetes is not controlled. Uncontrolled diabetes can cause heart attacks, stiffening of the arteries, and kidney damage. This makes it harder for your heart to pump and harder for the kidneys to eliminate excess fluid. Uncontrolled diabetes can also cause strokes, nerve damage, and vision problems.. Because you have heart failure, it is particularly important to control your blood sugar to help prevent further complications.
To reduce your risk of diabetes making your heart failure worse, keep a record of your blood sugars and share that information with your health care team. Also, take your medicines as prescribed, and follow your exercise and diet programs.
There are newer drugs now approved for the treatment of diabetes that can actually improve your overall heart health and heart failure as well. Ask your primary care provider if you are a good candidate for any of these new drugs.
If you have diabetes, you should ask your health care provider about any possible side effects of all your diabetes medicines on your heart failure.
Both heart failure and lung (also called pulmonary) diseases, such as chronic obstructive pulmonary disease or asthma, can cause you to experience shortness of breath. If you begin to have shortness of breath or trouble breathing and are not sure of the reason, ask your health care provider.
If you develop a new cough, it could be due to worsening heart failure, a respiratory infection, pulmonary disease, or a side effect from a heart failure medicine, such as your ACE (angiotensin-converting enzyme) inhibitor pills. Again, ask your health care provider, especially if your cough is keeping you awake at night.
Beta-blockers, another important type of medicine used to treat heart failure, can cause or aggravate bronchospastic symptoms in people with asthma. Bronchospastic symptoms are those that occur when your airways tighten and can include shortness of breath, wheezing, coughing, or difficulty breathing in or out. If you take a beta-blocker pill and have breathing problems, tell your health care provider. Do not stop these medications suddenly without consulting your health care team.
High blood pressure can make your heart work harder. It can make you feel weak, tired, and lead to more health problems.
The AHA recommends monitoring your blood pressure at home if you have heart failure and high blood pressure, and have been treated with medicines. You should record your blood pressure 1-2 hours after you take your heart failure medicines. This will help your health care team manage your heart failure and high blood pressure more effectively.
It is also important to understand what all of your medicines are intended to treat. Never stop taking your medicines without your health care provider’s approval. Do not adjust your dosage or make any other changes to the health care provider’s prescribing instructions.
Many of the medicines used to treat heart failure are also used to treat high blood pressure. These include ACE inhibitors, beta-blockers, diuretics (water pills), and angiotensin receptor blockers (ARBs). Some high blood pressure medicines may slow your heart rate (e.g., beta-blockers), and some may cause fluid retention. If you have questions about the side effects of any of your blood pressure medicines, you should contact your doctor or nurse.
Questions to Ask Your Doctor or Nurse
Do I have high blood pressure? What should my blood pressure be?
It is important for you to understand all of your chronic medical conditions, so the doctors and nurses involved in your care can develop a treatment plan that will work well for you. It is also easier to participate more actively in your own care if you understand the medical conditions affecting your health.
Should I check my blood pressure at home?
Ask your doctor or nurse if they recommend that you check your blood pressure at home.
Cholesterol is a specific type of molecule in the body that has many important functions. For example, it is used by the body to make some hormones and vitamins such as vitamin D. However if you get too much cholesterol or other types of “bad” fats in your diet, they can build up in your arteries and cause them to harden. This buildup also narrows your arteries and makes it more difficult for blood to flow through them as it should. One of the dangers of this buildup is that it can cause a blood clot, which can lead to a heart attack or stroke.
Having a heart attack damages heart muscle and can worsen heart failure. If you already have coronary artery disease and heart failure, it is important to work with your health care team to reduce your cholesterol levels to normal to decrease your risk of having a heart attack.
To manage your cholesterol, you should:
- Decrease your weight to expected levels for your height, especially if you are overweight or obese.
- Limit your fat and cholesterol intake and follow a low-sodium diet. Read food labels to be sure you are not choosing foods that are high in fat or sodium. (See Module 2: How to Follow a Low-Sodium Diet for information on how to read food labels and how to choose low-sodium foods.)
- Take statins or other medications to lower your LDL cholesterol, if prescribed by your health care provider.
- Exercise regularly after consulting with your health care provider.
People with heart failure can sometimes develop decreased kidney function. The interaction between heart failure and kidney function is very complex. For example, sometimes kidney function can decrease as a result of heart failure getting worse. There are also times when heart failure medications may contribute to worsening kidney function. Your health care team will monitor your kidney function through routine blood tests and may adjust your medications in response to changes in specific lab values obtained from these routine tests.
Your heart failure medicines and your diuretic (water pill) can be adjusted if you are retaining fluid in your legs or abdomen. Weigh yourself at the same time every morning to see how your body is managing fluid. If you gain 3 lbs. in 24 hours or 5 lbs. in a week, contact your health care provider.
If your kidney function worsens, your doctor or nurse will need to change some of your heart failure medicines.
Always take your diuretic and other heart failure medicines only as prescribed. Taking too much of some medicines can worsen your kidney function. (See Module 3: Heart Failure Medicines for information on taking diuretics and other medicines to treat heart failure.)
Too much body weight makes your heart work harder. People with a body mass index (BMI) of 30 or higher are considered obese and have a higher risk for such health problems as heart disease, stroke, high blood pressure, diabetes, and more. Obesity is also responsible for more hospital admissions.
If you are obese, it is important to lose weight. The best way to do this is to follow a well-balanced diet and to increase your level of physical activity. Talk with your health care team about whether you need to lose weight, how much you need to lose, and the best ways for you to do this.
Osteoarthritis is the most common form of joint disease as we age. People with heart failure may also have gout, painful swelling of the joints. Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically used to manage joint pain and other medical conditions. You can buy some NSAIDs over-the-counter, while others require a prescription. NSAIDs include medicines such as aspirin, ibuprofen, indomethacin, and naproxen.
In general, it is preferable to use acetaminophen to treat arthritis, and muscle or joint pain. Although there are many over-the-counter medicines for pain, it is important to know that NSAIDs must be used with caution in patients with heart failure because they can lead to fluid retention and worsening kidney function. Ask your health care provider about the best treatment for your arthritis.
Remaining active is one way to decrease the symptoms of arthritis and help you feel better when you have heart failure. (See Module 5: Exercise and Activity for ways to safely increase your activity level.) There are also alternative therapies that your health care team can recommend. You might meet with a dietitian to discuss a low-inflammatory diet or other ways of achieving a healthy weight.
Viewing and Printing the Module
Patients and caregivers may wish to download and read this PDF on a screen or to print and read this module on paper. HFSA has created a simplified printable version that makes it easy for you to print at home or from any printer on 8.5" x 11" standard paper. See options below.
Providers may wish to use this file in several ways:
- Download and read this PDF on a screen or email to patients and caregivers
- Print professionally using a printer such as Minuteman Press in a high resolution, pamphlet format at an additional fee to your institution (see additional instructions below)
- Print quickly and for free in-house using a simplified version that minimizes ink usage and uses an 8.5" x 11" standard paper size
Explore options below.
Instructions for Professional Printing
If you choose professional printing, HFSA recommends sending these details to your printer along with the file that you can download below:
1. Dimensions: 5.5" x 8.5"
2. Binding: Saddle Stitch
3. Bleeds/Crop: 0.125"
HFSA Patient Education Modules Overview
The Heart Failure Society of America (HFSA) has created a series of patient education materials, known as modules, to provide practical information on specific topics to educate and empower patients, caregivers, and their family members. Each module includes background information on the topic, questions they should ask their doctors or nurses, and more. This page contains information specific to Patient Education Module 8: Managing Other Chronic Conditions. Look below for information on downloading and printing this module.
Disclaimer
Patients should actively work with their health care providers to achieve the best outcomes. These modules are not intended to replace regular medical care.