What lifestyle modifications should be included in the cardiac rehabilitation plan for patients with heart failure?

Cardiac rehabilitation for patients with heart failure should include personalised, exercise-based programmes tailored to the individual's clinical stability and comorbidities, with the aim to improve functional capacity and quality of life ¹. Exercise training is a core component and should be adapted by qualified professionals to accommodate any clinical conditions that may worsen during physical activity ¹ (de Gregorio, 2018). The programme should be accessible in various settings such as home, community, or hospital, and include a psychological and educational component to support self-management and understanding of the condition ¹.

Lifestyle modifications integral to cardiac rehabilitation include:

• Encouraging regular, moderate physical activity tailored to the patient’s capacity and comorbidities, which has been shown to improve exercise tolerance and reduce symptoms (Passantino et al., 2021).
• Providing education on symptom monitoring and when to seek medical advice, empowering patients to participate actively in their care ¹.
• Incorporating stress management techniques as part of comprehensive rehabilitation to address psychological wellbeing ¹ (Passantino et al., 2021).
• Offering dietary advice consistent with heart failure management, such as sodium restriction and fluid management, although specific dietary guidelines should be personalised (Camafort et al., 2023).
• Supporting smoking cessation and moderation of alcohol intake, as these lifestyle factors impact heart failure progression (Camafort et al., 2023).
• Addressing social determinants and barriers to attendance, including transport and cultural sensitivity, to improve engagement and adherence ¹.

Overall, cardiac rehabilitation for heart failure patients should be holistic, combining physical training with education, psychological support, and lifestyle counselling to optimise outcomes ¹ (de Gregorio, 2018; Passantino et al., 2021; Camafort et al., 2023).