How long can you live with congestive heart failure?

Life expectancy with CHF may be nonlinear and dependent on several variables. A review highlights that many physicians do not feel they can confidently predict a patient’s clinical trajectory in a 6-month time frame.

A 2019 meta‐analysis estimates that the 1-, 2-, 5-, and 10‐year survival rates of all-type heart failure are 87%, 73%, 57%, and 35%, respectively. However, life expectancy for a person with CHF has substantially improved over time.

A person’s age at diagnosis may impact prognosis. The authors report that the 5-year survival rate for people under 65 years of age was around 79%, while the rate was about 50% for those 75 and over.

Additionally, how much blood a person’s heart pumps out per beat, known as the ejection fraction (EF), may affect life expectancy. Doctors will note a patient’s EF as a percentage, with a normal output falling between 50–70%.

Patients with an EF under 40% may be at a greater risk of dying from CHF. However, a 2017 study reports that the 5-year life expectancy is poor among all patients admitted to the hospital with heart failure regardless of their EF, with the estimated 5-year mortality at 75.4%. The above 2019 meta-analysis also found no significant difference in the survival rate between patients with an EF below 40% and those with one above.

The presence of underlying conditions, or comorbidities, such as coronary heart disease, can affect a person’s life expectancy. An age-adjusted study found that comorbidities are common in heart failure patients and contribute to higher death rates. Diabetes is present in 28% of deaths and chronic obstructive pulmonary disease (COPD) in 16%.

Risk factors, such as obesity, hypertension, and a poor diet may also negatively impact a person’s outlook.

CHF is not curable, but early detection and treatment may help improve a person’s life expectancy. Following a treatment plan that includes lifestyle changes may help improve their quality of life.

In a person with CHF, the muscles of the heart may become too stiff, or too weak, to pump blood efficiently. This means that instead of the heart pushing blood out, it collects in the heart. This blood that remains in the heart can cause fluid retention.

Doctors will often assess a patient’s functional capacity on the New York Heart Association’s classification system. The classes are:

• Class 1: A person has no limitation on their physical activity and no adverse symptoms.
• Class 2: There is a slight limitation on physical activity, but the person is comfortable at rest.
• Class 3: A person has a notable limitation on their physical activity, but they remain comfortable at rest.
• Class 4: A person cannot engage in physical activity without discomfort and experiences symptoms of heart failure at rest.

A second classification system, defined by the American College of Cardiology (ACC) and the American Heart Association (AHA), details four stages of heart disease. They are:

• Stage A: A person has a high risk of heart failure but currently has no identifiable disorders.
• Stage B: A person has a structural heart disorder but is not presenting with symptoms.
• Stage C: A person has current or prior symptoms of heart failure associated with an underlying condition.
• Stage D: A person currently has advanced structural heart disease, shows clear symptoms, and requires specialized medical intervention.

Common symptoms of heart disease include:

• swelling in the legs and feet or weight gain caused by a buildup of excess fluid
• bloating
• shortness of breath or waking up short of breath
• an inability to lie flat or needing to sleep on extra pillows
• fatigue
• nausea
• chest pain

Other conditions that affect the heart can also cause CHF. An early diagnosis of CHF may help people manage their symptoms and make preventative lifestyle changes.

Doctors will likely recommend making lifestyle changes to minimize the impact of CHF. This will often happen regardless of the stage a person is at or other treatments they will follow. According to a 2018 study, these changes may help slow the progression of heart failure conditions and increase a person’s quality of life. They include:

Diet and exercise

Eating a healthful, varied diet and getting regular exercise is always a good idea, but it can be essential for people with CHF.

Doctors may recommend that people with CHF eliminate excess salt, or sodium, from their diet, as it causes the body to retain fluids. They may also suggest reducing or limiting their alcohol and fluid intake.

Regular aerobic exercise may improve heart health and lead to a better quality of life in people with CHF. The guidance states that physical conditioning can improve a person’s quality of life and exercise tolerance, and it can reduce hospitalization rates in people with heart failure. However, an increase in physical activity may not be practical for everyone with CHF.

Aerobic exercise is any activity that elevates the heart and breathing rates. Such activities include swimming, cycling, or jogging. If you have CHF, check with a doctor before beginning any new exercises.

Fluid restriction

People with CHF tend to retain fluid in their bodies. To mitigate this, doctors will sometimes recommend that people limit their daily fluid intake within safe boundaries.

Consuming too much liquid may cancel out the effects of diuretic medicines. While it is essential to stay hydrated, a doctor can recommend just how much fluid a person can safely consume a day.

Weight

Obesity is a known risk factor for heart failure. Research shows that weight loss and subsequent management can be effective in the prevention of heart failure.

However, for people with CHF, a doctor may not always advise weight loss. In some circumstances, rapid weight loss may be a warning sign of other conditions, such as cachexia.

Doctors will often ask people to monitor their weight each day to check for any sudden or fast weight gains, which may be a sign of fluid retention. In addition, monitoring a person’s weight every day can help a doctor prescribe the correct levels of diuretics to help the body release fluid.

Each person with congestive heart failure will have a different experience with the condition, and life expectancy for the disease will vary significantly between individuals. Some studies estimate a 5-year survival rate of close to 50% for a person diagnosed with heart failure.

Life expectancy depends on what stage and class a person’s CHF has reached and what other complications or health problems they have. People who have received an early diagnosis may have a better outlook than those who did not.

Many people find that positive lifestyle changes can significantly improve their CHF symptoms and well-being. In addition, medications help many people with CHF. Doctors will sometimes recommend surgery.

A person with CHF should work directly with a doctor or medical team to make an individualized treatment plan to have the best possible outlook.