What lifestyle modifications should I recommend to patients with chronic heart failure to improve their quality of life?

Lifestyle modifications recommended for patients with chronic heart failure to improve quality of life include:

• Engage in regular, supervised exercise-based rehabilitation programmes tailored to the individual's stability and comorbidities, as these improve exercise capacity and quality of life without increasing mortality risk. Exercise should be gradual and may be home, community, or hospital based, including psychological and educational components. Avoid water-based exercise in advanced heart failure (NYHA class III/IV) due to risks from increased preload.
• Maintain a healthy diet and nutritional status by eating healthily, assessing nutritional status regularly, and providing dietetic advice if BMI is under 18.5 kg/m2 or over 30 kg/m2. A Mediterranean-style diet is generally advised.
• Manage weight by advising on achieving and maintaining a healthy weight, especially in obesity, to reduce heart failure burden.
• Screen and manage psychological health by screening for depression and anxiety, offering treatment or referral as appropriate, since psychological wellbeing affects prognosis and adherence.
• Provide personalized education and support to help patients understand their condition, treatment, and self-care, enhancing involvement in management.
• Ensure vaccinations such as annual influenza and once-only pneumococcal vaccines to reduce infection risk.
• Advise on sexual activity reassuring that stable heart failure patients can safely engage in sexual activity that does not provoke symptoms.
• Offer advice on travel and driving based on current guidelines to ensure safety and confidence.

These lifestyle modifications collectively aim to improve functional capacity, reduce hospital admissions, and enhance quality of life in chronic heart failure patients ¹,².