Heart Failure in Older Adults
Plain-language information about heart failure in older adults. This page is for older Canadians and their caregivers. It does not replace advice from your own health-care provider.
1. What is heart failure?
Important to understand
Heart failure means the heart is not pumping blood as well as it should to meet the body's needs. It does not mean the heart has stopped.
When the heart is weaker or stiffer than normal:
- Less blood and oxygen reach the body
- Fluid can build up in the lungs, legs, or other parts of the body
Common signs and symptoms
2. Why heart failure matters more in older adults
Heart failure is more common in older adults and can cause:
- Reduced ability to walk, climb stairs, or carry out daily activities
- Higher risk of hospital stays and complications
- More complex medication regimens (often several heart medicines together)
- Increased risk from infections, dehydration, or other illnesses
For older adults
Because many older adults also have high blood pressure, diabetes, kidney disease, or lung disease, managing heart failure often requires careful balancing of medications, fluids, and activity.
3. How doctors usually treat heart failure
Health-care providers often consider:
- The type of heart failure (heart too weak to pump vs. too stiff to fill)
- How severe your symptoms are
- Results from tests (such as echocardiograms, blood tests, ECGs)
- Other medical conditions
- All medications you already take
Treatment commonly includes:
Help the heart pump, relax blood vessels, remove extra fluid
Limiting salt, watching fluid intake if advised
Tracking weight and symptoms
Pacemakers or defibrillators if recommended
Important
This website does not tell you which medications, doses, or devices are right for you. Only your heart specialist or primary provider can decide that.
4. Common types of heart failure medicines in older adults
Health-care providers often use several medications together:
Diuretics ("water pills")
Help remove extra fluid and reduce swelling and breathlessness
ACE inhibitors or ARBs
Help relax blood vessels and reduce strain on the heart
Beta blockers
Help slow the heart rate and reduce its workload
Mineralocorticoid receptor antagonists
Such as spironolactone – help remove salt and may protect the heart
Newer heart failure medications
Used in certain situations based on current guidelines
Regular monitoring
Your provider will often check your blood pressure, pulse, weight, swelling, and blood tests (kidney function, electrolytes) to ensure your medications are working safely.
5. Possible side effects older adults may notice
Things to watch for and report include:
Do not stop suddenly
Do not stop your heart medications suddenly unless your provider tells you to. Stopping some heart medications without medical advice can be dangerous.
6. Habits and lifestyle that may help
Many heart failure guidelines suggest that certain daily habits may help manage symptoms along with medical care. What is safe and realistic is different for each person.
Food and salt (sodium)
- Being mindful of salt intake, as excess salt can cause the body to hold on to fluid
- Tasting food before adding salt; using herbs, spices, lemon, or vinegar for flavour
- Limiting very salty processed foods (many canned soups, cured meats, salty snacks)
Fluids
Important
Some people with heart failure are given a fluid limit. Follow the instructions from your health-care provider. Do not restrict fluids unless you have been specifically told to do so.
Movement and activity
- Gentle, regular activity (short walks, simple exercises) can sometimes help with stamina
- Rest is important, but complete inactivity can weaken muscles over time
- Balance rest and gentle movement as advised by your provider
Always ask first
Always ask your health-care provider which food and fluid changes are safe for you, and what types of activity are safe. Do not change salt, fluids, or exercise without checking first.
7. When to call your doctor, nurse practitioner, or heart failure clinic
(Non-urgent)
Contact your health-care provider if:
More than your provider has told you is safe (often 2–3 lbs in a day or 5 lbs in a week)
In your legs, ankles, or belly than usual
Doing your regular activities
To sleep because of breathlessness
Unsure how to take or adjust your medications
8. When to call 911 or go to the emergency department
Call 911 immediately if:
- You are struggling to breathe, even at rest
- You have chest pain or pressure that does not go away
- You wake up suddenly feeling like you cannot catch your breath
- Your lips or fingers look blue or grey
- You feel like you are going to faint, or you do faint
If possible, do not drive yourself. Ask someone to call for you or call an ambulance.
9. Questions to ask your doctor or nurse practitioner
You can print these questions and bring them to your next appointment: