Heart failure with preserved ejection fraction (HFpEF) is a type of heart failure that affects how your heart fills with blood. This guide explains the condition, its causes, symptoms, treatments, and how to manage living with it.
What is Heart Failure with Preserved Ejection Fraction (HFpEF)?
Heart failure occurs when your heart cannot pump blood effectively to meet your body’s needs. In HFpEF, the heart’s pumping function (ejection fraction) remains normal, but the heart muscle becomes stiff or less flexible. This stiffness makes it harder for the heart to fill properly with blood between beats, leading to symptoms like breathlessness and fatigue.
HFpEF is sometimes referred to as diastolic heart failure, as it primarily affects the diastolic phase (when the heart relaxes and fills with blood).
Key Facts About HFpEF
Background
- HFpEF accounts for about half of all cases of heart failure.
- It is becoming more common due to the ageing population and increasing rates of conditions like high blood pressure and obesity.
Causes
HFpEF is typically caused by conditions that make the heart muscle stiff or impair its ability to relax. Common causes include:
- High blood pressure (hypertension): Over time, this can thicken and stiffen the heart muscle.
- Obesity: Excess weight can strain the heart and contribute to inflammation.
- Diabetes: High blood sugar levels can damage blood vessels and the heart muscle.
- Coronary artery disease: Blockages in the arteries supplying blood to the heart can lead to stiffness.
- Atrial fibrillation: An irregular heartbeat can worsen HFpEF symptoms.
Incidence and Prevalence
- Incidence: Refers to new cases diagnosed each year; HFpEF accounts for about 50% of all new heart failure cases worldwide.
- Prevalence: Approximately 1–2% of the general population has HFpEF, but this increases significantly with age. Among people over 70 years old, up to 10% may have HFpEF.
Who is Affected?
- Age: HFpEF is more common in older adults, typically over the age of 60.
- Gender: Women are more likely than men to develop HFpEF, possibly due to hormonal differences and higher rates of hypertension in older women.
- Ethnicity: HFpEF affects all ethnic groups but may be more prevalent in populations with higher rates of hypertension or diabetes.
Geographic Distribution
- HFpEF occurs globally but is more common in developed countries where risk factors like obesity and sedentary lifestyles are prevalent.
How Does HFpEF Impact You?
Symptoms
The symptoms of HFpEF are similar to other forms of heart failure and may include:
- Shortness of breath, especially during physical activity or when lying down.
- Fatigue or low energy levels.
- Swelling in the legs, ankles, or feet (oedema).
- Difficulty exercising or performing daily activities due to breathlessness or tiredness.
These symptoms can significantly affect your quality of life and ability to perform routine tasks.
Living With Heart Failure with Preserved Ejection Fraction
Living with HFpEF often involves managing symptoms through lifestyle changes, medications, and regular medical care. It’s important to monitor your symptoms and communicate any changes to your healthcare provider.
Expected Life Expectancy
HFpEF is a chronic condition that requires ongoing management. While it can reduce life expectancy compared to people without heart failure, advances in treatment have improved outcomes for many patients.
Managing and Treating HFpEF
Available Treatments
There is currently no cure for HFpEF, but treatments aim to relieve symptoms, improve quality of life, and address underlying conditions:
- Medications:
- Diuretics: Help reduce fluid buildup in your body, relieving swelling and breathlessness.
- Mineralocorticoid receptor antagonists (MRAs): Medications like spironolactone may help reduce hospitalisations for some patients.
- Sodium-glucose co-transporter 2 (SGLT2) inhibitors: Originally used for diabetes, these medications have been shown to improve outcomes in people with HFpEF.
- Medications for underlying conditions like high blood pressure or atrial fibrillation may also be prescribed.
- Lifestyle Changes:
- Maintain a healthy weight through a balanced diet.
- Limit salt intake to reduce fluid retention.
- Engage in regular physical activity appropriate for your condition.
- Avoid smoking and limit alcohol consumption.
- Management of Underlying Conditions: Treating conditions like hypertension, diabetes, or atrial fibrillation can help prevent worsening symptoms.
- Cardiac Rehabilitation: A supervised exercise programme tailored to your needs can improve fitness and quality of life.
Ongoing Clinical Research
Research into HFpEF continues to explore new treatments and a better understanding of the condition:
- Targeted Medications: Studies are investigating drugs that address specific mechanisms involved in HFpEF, such as inflammation or fibrosis (scarring) of the heart muscle.
- Biomarkers: Researchers are identifying biomarkers (measurable indicators) that could improve diagnosis and help tailor treatments.
- For information on clinical trials related to HFpEF, you can visit gov.
Support Groups and Resources
If you have been diagnosed with HFpEF, connecting with support groups can provide valuable information and emotional support:
- British Heart Foundation (BHF) (org.uk)– Offers resources for individuals living with heart failure.
- Heart Failure Matters (org)– Provides educational materials on managing heart failure.
- Pumping Marvellous Foundation (org)– A UK-based patient-led organisation offering support for people living with heart failure.
- American Heart Association (AHA) (org)– Offers global resources on cardiovascular health.
Remember:
This information is intended for general knowledge and educational purposes only and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
