Heart failure (HF) contributed to 1 in 8 of adult deaths in the United States in 2017. About 6.5 million American adults have been diagnosed with heart failure, which is a challenge to treat.

How do we best work with this difficult diagnosis? Regardless of where people are in terms of heart failure’s progression, we want to build care around their Mission, Aspiration, and Purpose (MAP), truly engaging them in their care and developing a multifaceted Personal Health Plan (PHP).

While we want to optimally support people wherever they may be with this diagnosis, the optimal—though not always possible—way is to prevent its development in the first place. Lifestyle and dietary measures promoting heart health are ideally woven into a person’s life before any problems even arise. This Integrative Whole Health tool explores how aspects of self-care such as Nutrition, Mind and Emotions, Physical Activity, Recharge, and other factors have an influence.

Professional care is also fundamental. Careful lifelong surveillance for and active treatment of hypertension, diabetes, obesity, and coronary artery disease (CAD) is essential. Complementary and Integrative Health (CIH) approaches can play an important role as well. This clinical tool will briefly review conventional approaches to HF and then provide an overview of some of the most recent research surrounding self-care and CIH approaches that are helpful for clinicians to know.

Conventional Medical Wisdom

Heart failure (HF) results when the heart’s structure or function make it unable to fill with blood or eject blood as effectively as it normally would. People with heart failure have fluid retention (edema), shortness of breath, and fatigue, all of which may worsen over time.¹ Conventional medical therapy represents the centerpiece of treatment for people with symptomatic heart failure, with CIH approaches (discussed below) playing an adjunctive role. General treatment goals include:²

• Preventing progressive cardiovascular deterioration
• Minimizing symptoms and enhancing quality of life
• Increasing survival

Physiologic aims of treatment in the setting of significant left ventricular dysfunction (left ventricular ejection fraction [LVEF] less than 45%) are:

• Reducing preload and afterload
• Maintaining stable left ventricular function
• Limiting activation of the renin-angiotensin-aldosterone system