Heart failure with preserved ejection fraction (HFpEF) is a common condition where the heart struggles to meet the body’s needs. How long one can live with HFpEF is highly individualized, influenced by various factors that impact its progression.
What is HFpEF?
Heart failure with preserved ejection fraction (HFpEF) occurs when the left ventricle stiffens and cannot relax properly to fill with blood. This differs from heart failure with reduced ejection fraction (HFrEF), where the heart muscle is weakened and struggles to pump blood out effectively. In HFpEF, the “ejection fraction”—the percentage of blood pumped out with each beat—remains normal (typically 50% or higher), yet the heart’s ability to fill and pump blood is often insufficient for the body’s demands.
The heart’s reduced ability to fill leads to fluid backup, causing symptoms like shortness of breath (especially with exertion or when lying flat) and fatigue. Swelling in the legs, ankles, or feet due to fluid accumulation is also common. Various chronic conditions contribute to the heart muscle’s stiffening over time, leading to HFpEF.
Key Factors Affecting Life Expectancy
Life expectancy with HFpEF is highly individualized, shaped by several factors. The presence and severity of other health conditions, known as comorbidities, significantly influence the overall outlook. Conditions such as chronic kidney disease, diabetes, obesity, lung disease, and atrial fibrillation can worsen the burden on the heart and influence disease progression.
The age at which HFpEF is diagnosed also plays a role, as the condition is more prevalent in older adults. The advancement of heart failure, often categorized by symptoms using the New York Heart Association (NYHA) functional class, also influences prognosis. Individuals with more severe symptoms generally face a more challenging course. How well a person responds to prescribed medications and lifestyle adjustments is another significant determinant.
Lifestyle choices, including a heart-healthy diet, regular physical activity, smoking cessation, and moderate alcohol intake, are also important. Consistent medical follow-up and adherence to treatment plans are necessary for monitoring the condition and adjusting therapies. These factors underscore the individualized nature of HFpEF, meaning a single prognosis does not apply to everyone.
Strategies for Managing HFpEF
Managing HFpEF involves a multifaceted approach to alleviate symptoms and improve quality of life. A central strategy is strict control of underlying health conditions that contribute to HFpEF, including diligent management of high blood pressure, diabetes, high cholesterol, and kidney disease.
Medications play a role in managing symptoms and associated conditions. Diuretics reduce fluid retention, easing symptoms like swelling and shortness of breath. Other medications may control blood pressure or manage comorbidities. Recently, certain medications, such as SGLT2 inhibitors, have shown promise in improving outcomes for some individuals with HFpEF.
Lifestyle modifications are also important. A heart-healthy diet, typically involving reduced sodium intake, helps manage fluid balance and blood pressure. Regular, doctor-approved physical activity, maintaining a healthy weight, avoiding smoking, and limiting alcohol consumption support heart health and overall well-being. Monitoring daily fluid intake and body weight also provides useful information for managing fluid levels.
Coping and Support for HFpEF
Living with a chronic condition like HFpEF can impact emotional well-being, making support systems important. Acknowledging the emotional toll and seeking support through counseling or patient support groups can help navigate challenges. Open communication with the healthcare team is also important for discussing symptoms, concerns, and treatment plans.
Engaging family, friends, and community resources provides a strong network of practical and emotional support. These connections can help manage daily tasks and maintain a sense of normalcy. Discussions about palliative care can also be valuable at any stage of HFpEF to enhance comfort and quality of life.
Advanced care planning allows individuals to express preferences for future medical care. This proactive step ensures personal values and wishes are respected in healthcare decisions. Addressing these non-medical aspects contributes to a more holistic approach to living with HFpEF.