Congestive Heart Failure: Life Expectancy and Prognosis

Left Ventricular Ejection Fraction and Mortality
 LVEF  Mortality
 ≤15%  51%
 16–25%  41.7%
 26–35%  31.4%
 35–45%  25.6%

Diabetes

Type 2 diabetes is a factor that increases the risk of poor outcomes in people with CHF. Research has found that people with diabetes are two to four times more likely to develop CHF than people without diabetes. As many as 47% of people with heart failure also have diabetes. And many people with CHF have diabetes that has gone undetected and not been diagnosed.

A study of 150 people with heart failure assessed them for previously undiagnosed prediabetes and type 2 diabetes. Of this group, 43% were found to have prediabetes, and 19% had diabetes.

During two years of follow-up, compared to the people without prediabetes or diabetes, those with prediabetes were 2.6 times more likely to die of any cause, and almost three times as likely to die of cardiovascular causes, such as heart attack, stroke, or worsening heart failure. People with diabetes were more than five times as likely to die of any cause, and almost 10 times as likely to die of cardiovascular causes.

Hospitalization

Heart failure that requires hospitalization is associated with poor outcomes. People who have multiple hospitalizations often have other serious medical conditions and are at greater risk of death, particularly death from cardiovascular causes. 

Recap

Many factors affect the survival of CHF patients. Your age, sex, and even your physical ability to exercise all contribute to your possible outcomes. The type and stage of your CHF also matter. So do the heart-related and other health conditions you may have along with CHF. One of the most significant risk factors is diabetes. For this reason, people with both diabetes and heart failure often are treated by heart specialists.

What You Can Do

Some risk factors of heart failure, like age, can’t be modified. Still, people with CHF can take steps to improve the long-term prognosis. The first thing to do is to be familiar with any family history of heart disease. You’ll also want to learn about all the possible symptoms. Don’t ignore any symptom that you think is cause for concern. Tell your healthcare provider about them right away.

Regular exercise, along with managing any other health issues you may have, can also help to keep CHF under control.

Exercise

If you are diagnosed with heart disease, then weight loss alone does not lower your mortality risk. Yet ongoing and sustained physical activity is associated with some risk reduction.

An analysis of data from the Heart Failure Adherence and Retention Trial compared people with heart failure who engaged in 150 or more minutes a week of moderate activity or 75 or more minutes a week of vigorous activity (the “ideal” group) with those who got less (“intermediate”) or no moderate or vigorous activity (“poor”).

In the 2.4 years of follow-up, compared to the ideal group, the other groups were almost twice as likely to be hospitalized, and more than four times as likely to die of cardiovascular causes. The intermediate group was twice as likely to die of any cause, and the poor group was almost three times as likely to die of any cause.

A 2018 study published in the Current Obesity Reports suggests that a sustained weight loss of more than 5% of total body weight will lead to better control over blood sugar levels and lower the risk of heart-related factors. Healthy lifestyle choices, including diet and exercise, can help. So can medication or surgery to manage weight. Be sure to talk to your healthcare provider before you begin any sort of weight-loss program.

Diabetes Control

Diabetes has been linked to the risk of heart failure. Among people with diabetes, 25% have chronic heart failure and up to 40% have acute heart failure. For this reason, people with both diabetes and heart failure are treated by cardiologists (heart specialists). To reduce the risk of death, good blood sugar control is key.

Angiotensin-converting enzyme (or ACE) inhibitors are often used to help treat both type 1 and type 2 diabetes with heart failure. ACE inhibitors offer a number of benefits, and are linked with a lower death rate and fewer hospitalizations. Angiotensin II receptor blockers, or ARBs, have shown similar benefits in heart failure patients with and without diabetes.

Medications

In heart failure with reduced ejection fraction, a few drugs have been shown to reduce deaths and hospitalizations. Healthcare providers may prescribe the following medications in some combination:

  • Beta-blockers (carvedilol, metoprolol succinate, or bisoprolol)
  • Entresto (sacubitril with valsartan)
  • An ARB or ACE inhibitor
  • Spironolactone
  • Sodium glucose co-transporter 2 (SGLT2) inhibitors
  • Ivabradine

In heart failure with preserved ejection fraction, no medications have been shown to improve mortality except diuretics. There is some evidence that spironolactone may also offer a benefit.

Heart failure prognosis has improved due to new drug therapies. Still, how effective these drugs are can change over time. Tell your cardiologist about any new symptoms, or those that get worse. They can evaluate you for possible changes in your treatment. 

Summary

The left ventricle is the chamber of the heart that forces blood out into the body. When it no longer works properly, the amount of blood it forces out into the body is not adequate for its needs.

This can happen because the heart muscle is too weak, causing what’s called a reduced ejection fraction. It also can happen due to the muscle becoming stiff and unable to relax, as is the case with preserved ejection fraction.

These fractions are used to measure how well your heart is working. Along with other factors, such as age or additional health problems, they contribute to an assessment of how serious or advanced your CHF has become. This helps healthcare providers to offer you the most accurate estimates possible when it comes to your disease progression and your life expectancy.

A Word From Verywell

The prognosis for CHF may seem discouraging, but there are lifestyle changes and medications that can help. They can slow down CHF progression and boost your chances of survival. You can be proactive by monitoring your symptoms and putting unhealthy habits aside. Regular exercise and a healthy diet can help.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Rebeca Schiller

Rebeca Schiller is a health and wellness writer with over a decade of experience covering topics including digestive health, pain management, and holistic nutrition.

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