If you have congestive heart failure, your life expectancy can depend on multiple factors, including your age and stage at diagnosis, heart function, and overall health.

Congestive heart failure (CHF) is a condition that occurs when the muscles of your heart are no longer able to pump blood effectively. This can lead to a variety of other health problems.

Sometimes referred to simply as heart failure, CHF is a long-term condition that can get worse over time. However, treatment can slow, stabilize, or improve the condition. Let’s discuss how the prognosis and survival rate can vary.

There are many factors affecting the outlook for CHF, your doctor will have the most information on your specific situation.

Some of the major factors generally affecting CHF outlook include:

  • age at diagnosis
  • why you have CHF
  • alcohol use
  • gender
  • stage at diagnosis
  • your heart’s ejection fraction
  • how many times you’re hospitalized for CHF symptoms
  • whether you have any other medical conditions
  • how well you respond to treatment
  • how well you follow your treatment plan

According to older research published in 2008, there’s a higher risk of CHF in African American individuals compared with white and Hispanic individuals when hypertension and diabetes, as well as social and economic factors, are present.

Prognosis at each stage

The outlook for CHF varies greatly between people, as there are many contributing factors for every individual’s situation. However, generally speaking, if CHF is discovered in its earlier stages and properly managed, you can expect a far better outlook than if it’s discovered much later.

Some people whose CHF is discovered early and treated promptly and effectively can hope to have a nearly standard life expectancy.

Prognosis by ejection fraction

Ejection fraction (EF) is a measure of how much blood is pumped out of your heart each time it contracts. A healthy heart has an EF of between about 55 percent to 75 percent.

Some people with CHF have a reduced EF. This means their heart is pumping less blood out to the rest of their body than a healthy heart. Studies have shown that people who have CHF and a reduced EF have a more challenging outlook than people with CHF who do not have a reduced EF.

The exact survival rates varied among studies, but all studies have shown that EF has an impact on prognosis. Your doctor will have the best information about how your ejection fraction can affect your prognosis.

Prognosis at different ages

In general, younger people diagnosed with CHF tend to have a better outlook than older people.

A report averaging several smaller studies found that people under age 65 generally had a 5-year survival rate of 78.8 percent following CHF diagnosis. The same report found that people over age 75 had an average 5-year survival rate of 49.5 percent following diagnosis.

Older people diagnosed with CHF may already have other chronic health conditions. This can make it difficult to manage CHF and create a more challenging outlook for them.

There are several treatment options for congestive heart failure. The treatment that’s best for you will depend on:

  • your overall health
  • any other health conditions you have
  • how you respond to any medications
  • what stage of CHF you have

Common options include:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors. SGLT2 inhibitors may be used if you also have type 2 diabetes to help protect your kidney and heart function.
  • Angiotensin receptor-neprilysin inhibitor (ARNI). ARNI is a combination of two other drugs (sacubitril and valsartan) and can reduce high blood pressure.
  • Verquovo. This is a guanylate cyclase stimulator that has been shown to decrease the chance of death from heart failure.
  • I(f) channel blockers (ivabradine). They can help reduce heart failure symptoms by lowering the heart rate.
  • Spironolactone (MRAs). MRAs are sometimes used to treat hypertension when your conditions are resistant to other treatments.
  • Beta-blockers and other heart medications. Medications like beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) can help your heart pump more blood.
  • Diuretic medications (water pills). Diuretics can help your body retain less water. Commonly used diuretics include bumetanide, furosemide, and toresemide.
  • Nitrates. Nitrates are a type of medication that can help reduce chest pain.
  • Blood thinnners. Blood thiners are medication that can help prevent blood clots.
  • Coronary bypass surgery. CHF can occur because your arteries are clogged. In this case, you might have coronary bypass surgery, which removes parts of healthy arteries from other parts of your body, such as your legs, and connects them to the damaged arteries around your heart.
  • Implantable cardioverter-defibrillators (ICDs). An ICD is similar to a pacemaker. It’s implanted in your chest and monitors your heart’s rhythm. If your heart falls into a dangerous rhythm, the ICD can shock it back to a healthy one.
  • Cardiac resynchronization therapy (CRT). A CRT device helps the chambers of your heart work together. It can be used with an ICD to keep your heart in rhythm.
  • A left ventricular assisted device (LVAD). LVADs are pumps that help increase the heart’s ability to squeeze. They’re sometimes used for end stage heart failure.
  • A heart transplant. A heart transplant can be a solution to CHF. However, in certain situations, an older person may not be considered a good candiate for a transplant. In these cases, an LVAD would not offer a permanent solution.

There are lifestyle changes a person with CHF can make that have been shown to help slow the condition’s progression. Talk with your doctor before making changes to your diet or starting an exercise routine.

Diet

Sodium causes fluid retention to increase within the body’s tissues. A low sodium diet is often recommended for people with CHF.

It’s also advisable to restrict your alcohol consumption and caffeine intake as both substances can affect your heart muscle, causing weakness.

The American Heart Association recommends limiting coffee intake to no more than two cups and limiting alcohol to no more than two drinks a day for men and one drink a day for women.

Exercise

Aerobic exercise has been shown to improve the heart’s overall ability to function, which supports a better quality of life and potentially increases life expectancy.

Your healthcare team can help you plan exercise programs tailored to your individual needs and tolerance levels.

Fluid restriction

People with CHF are often advised to regulate their fluid intake, which affects the overall fluid retained within the body. People taking diuretic medication to eliminate excess fluid can counteract the effects of this medication if they’re consuming too much fluid.

People with more advanced cases of CHF are usually advised to limit their overall fluid intake to 2 quarts.

Weight monitoring

An increase in body weight is an early sign of fluid accumulation. People with CHF are advised to monitor their weight closely. If you have gained 2–3 pounds in as many days, call your doctor.

They may want to increase your dose of diuretics to manage the fluid accumulation before it becomes more severe.

Quit smoking

Smoking is hard on your heart. It can increase your heart rate and blood pressure. People who quit smoking often see an improvement in their CHF symptoms.

Clothing choices

Very tight clothing, especially worn on your legs, can increase the risk of blood clots, so it’s best to limit this type of legwear if you have CHF.

Try to avoid getting overly hot in your clothes or wearing clothes that won’t keep you warm enough. Dressing in layers that you can remove or carrying items like sweaters or hoodies with you can be a good idea.

Take care of your mental health too

While stress is never pleasant, it can be especially hard on your heart. Anger management is also an important aspect of heart health.

Talking with a therapist or joining a support group can help with keeping your stress levels down and giving you accountability for the lifestyle changes you’re making.

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The outlook for those with CHF varies incredibly. It largely depends on what stage of the condition you’re in and whether you have other health conditions.

Younger people may also have a more promising outlook. Lifestyle changes, medication, and surgery can greatly improve your condition. Talk with your healthcare team to determine what the best treatment plan is for you.