Behavioral Medicine Treatments for Heart Failure

Abstract

Heart failure (HF) is a major public health concern affecting millions of people worldwide, with rates dramatically increasing as the population ages. HF is often the end stage of various cardiovascular disorders that result in myocardial hypertrophy and leading to the ultimate failure of the left ventricle. Behavioral and psychosocial risk factors that contribute to cardiovascular diseases can subsequently contribute to HF as an outcome. Behavioral risk factors for HF include a sedentary lifestyle, poor medication adherence, inadequate dietary habits resulting in suboptimal control of glucose levels or obesity, and abuse of alcohol or stimulants. Depression is common in HF and associated with poor prognosis and mortality. An often-neglected feature of the treatment of HF involves lifestyle changes and improved adherence to medications. Telehealth can be an important intervention that can reduce HF hospitalizations by educating patients about diet modifications (e.g., sodium and fluid restriction) and regular weight monitoring and by directing changes in diuretics and other medications. Exercise is beneficial in maintaining overall functional capacity in HF. Interventions that have both psychosocial benefits and physical activity benefits such as yoga and tai chi may be valuable for reducing depression, increasing physical function, and ultimately improving quality of life in patients with HF.