Lifestyle management

Treatment for cardiomyopathy often includes medication, and some people will have devices (such as an ICD or pacemaker) or surgery to support their heart and help control symptoms of their condition. 

There are also lifestyle management strategies which may help to reduce the strain on the heart, and help to manage and reduce the impact of cardiomyopathy. 

With all of the suggestions below, we recommend that you talk to your cardiologist, nurse or GP if you have any queries or questions about your lifestyle. You may also like to call our helpline .

Healthy eating and a healthy weight

What is a ‘healthy diet’ will vary from person to person, and is influenced by many factors including age, gender, lifestyle and any additional factors such as illness or medical conditions. In general, healthy eating is about eating the right sorts of food, in the right amounts, to keep fit and healthy. It includes eating essential food groups, such as proteins, carbohydrates and fats as well as vitamin and minerals. These are all important for the body to work and carry out vital functions such as growing, fighting disease and repairing the body, as well as giving energy to live life.

A healthy diet is also important for the health of the body’s vital organs – including the heart. A healthy diet can also help you to keep a healthy weight, which also help’s the heart to function at its best.

Being overweight can lead to high blood pressure and high cholesterol. It can increase your risk of type 2 diabetes and stroke. 

Being overweight can also cause added strain on the heart and the lungs, and for a heart with cardiomyopathy this can cause additional pressure. It can also increase your risk of coronary heart disease.

Read more about healthy eating from NHS Choices (opens new window).

Omega 3

Omega 3 is an essential fatty acid. There are three types, called EPA, DHA and ALA. They are found in some fish (such as mackerel and salmon), as well as nuts (such as pecans and walnuts) and seeds (such as linseeds). Omega 3 is essential for your body, as it helps the heart and brain to function.

Omega 3 has many benefits: it has anti-inflammatory properties, lowers levels of certain fats (called triglycerides) in the blood and helps with stiff and painful joints. It can also help to lower blood pressure (by dilating the blood vessels, making it easier for blood to flow).

Some research studies have shown that omega 3 is beneficial for people with dilated cardiomyopathy who have mild to moderate heart failure and are on standard treatment, as it improved the function of their left ventricle. However, these studies cannot confirm that taking omega 3 supplement will help everyone, and it is not a standard recommendation for people with cardiomyopathy. You may like to talk to your doctors about taking Omega 3 if you are considering this.

Salt

Salt, or sodium chloride, is an essential nutrient that is needed by the body to work. It is used to control fluid balance and blood pressure, as well as helping your muscles and nerves to work. However, high levels of salt also causes the body to retain water, which can increase the amount of fluid in the body and cause swelling in the ankles and tummy. This increases the workload on the heart and can contribute to high blood pressure (called hypertension) which can be a risk factor for developing heart disease and strokes.

Salt is found in many different processed food items, as well as being added to food directly. It can be found in ‘sweet’ food (such as cakes and biscuits) as well as more obvious ‘salty’ food (such as crisps and nuts). Sometimes food labelling lists ‘sodium’ rather than salt, but they are the same thing. Although the amount of salt it is safe to have varies, many people have too much. 

Minimising salt levels helps to reduce the risk of high blood pressure, heart disease and stroke. Reducing the food you each that contains salt, choosing low-salt options, and reducing any additional salt you add to your food, can help to reduce your overall salt intake. The labelling on food will list the salt content.

It is recommended that you avoid salt substitutes as they contain potassium, and can increase your potassium to harmful levels.

Read more about salt from NHS Choices (opens new window).

Alcohol

Alcohol can have several negative effects on your heart. It can raise your heart rate and cause arrhythmias (abnormal heart rhythms), and increase your blood pressure. It can also cause damage to the muscle of the heart. For someone with cardiomyopathy, whose heart is already under pressure and may be struggling to function normally, alcohol can add to this strain. For these reasons, it is advisable to minimise the amount of alcohol you drink. 

Alcohol can also have other effects, including:

  • causing diseases such as stroke, liver problems and some cancers;
  • causing weight gain, as it is high in calories; and
  • making depression and anxiety worse in someone who has these conditions, as it is a mood depressant.

You may not need to completely avoid alcohol, but keeping within the standard guidelines is generally recommended, particularly to reduce any effect on the heart. The guidelines for alcohol were reviewed by the Chief Medical Officer in 2016. Read more here (opens new window).

Alcohol and dilated cardiomyopathy (DCM)

Excessive alcohol can lead to the development of dilated cardiomyopathy (DCM). Where alcohol causes DCM it is recommended that you completely avoid alcohol.

Read more about DCM.

Alcohol and medication

Alcohol can interact with some medications, and can make them less- or non-effective.  For example, many people with cardiomyopathy take warfarin – an anticoagulant taken to reduce the tendency of the blood to clot (for people at risk of clots forming and causing a stroke). Alcohol can increase the effect of warfarin, which can increase the risk of bleeding.

Alcohol can also cause effects such as nausea and vomiting, poor coordination, headache and disrupted sleep. This can apply to prescription medication as well as over-the-counter (non-prescription) medication.

The patient information leaflet that comes with medication will usually have information and advice about drinking alcohol while taking the medication. You can talk to your doctor, cardiologist or pharmacist about any possible reaction between alcohol and particular medication you are taking.

Smoking

As well as being a leading cause of some cancers, and causing lung conditions, there are various ways in which smoking can affect the heart.

  • The nicotine in cigarettes is a stimulant, and causes the body to release adrenaline. Sometimes referred to as the ‘fight or flight’ hormone, adrenaline increases the heart rate and raises blood pressure (so that your body is prepared to ‘fight’ or ‘flee’ any danger). This increases the pressure that the heart is under to work.
  • Smoking can affect the inner lining of some blood vessels (arteries), causing them to become damaged. This is caused by fatty material building up in the arteries, which leads to the development of atheroma (areas of damage in the artery walls due to fatty material and scarring). This narrows or blocks the arteries, making it harder for blood to travel through and reducing the oxygen getting to the body’s tissues.
  • Where blood flow is reduced in the coronary arteries (the arteries that give the heart’s chambers their own supply of blood to function), it reduces the blood reaching the heart muscle. This causes added strain on the heart, can cause chest pain (called angina) and lead to coronary heart disease (where the oxygen levels reaching the blood are reduced, which can lead to a heart attack). People who smoke are more likely to have a heart attack than people who have never smoked.
  • Smoking can also make blood more likely to clot. This is because the platelets in the blood are more likely to stick together and form clots, and because the damage to the inner lining of the arteries (see above) also makes clots more likely to form due to the build up of atheroma. Blood clots can lead to a stroke or heart attack.
  • The carbon monoxide in cigarette smoke reduces how much oxygen can be carried in the blood. This not only means that the heart is under greater pressure to supply oxygen to the body, but it also results in reduced oxygen getting to the heart, as well as other areas of the body.

Smoking is a major risk factor for heart disease, and should be avoided by people with cardiomyopathy. If you smoke, stopping smoking can be one of the most important things you can do to help your heart health.

For more information about stopping smoking, how your GP can help, and details of the NHS stop smoking services, visit NHS Choices (opens new window).

Signup to the NHS smokefree service (opens new window).

Caffeine

Information about caffeine’s effect on the heart can be conflicting: research seems to suggest that there may be risks for some people, and someone’s reaction to caffeine can be individual.

Caffeine can cause arrhythmias (abnormal heart rhythms) and palpitations (feeling your heart beat), in some people. This is because caffeine is a stimulant: it stimulates the nervous system to release adrenaline, causing the heart rate and blood pressure to rise. This can be a problem for some people with reduced heart function.

Caffeine can also act as a diuretic, which is important to be aware of if you are on diuretics or if your nutrients levels (for example, sodium, magnesium and potassium) may be an issue.

It is likely that some people are more sensitive to the effects of caffeine on their heart that other people are. So for anyone who is sensitive, limiting tea and coffee with caffeine, and avoiding items high in caffeine (such as energy drinks, strong coffee and high cocoa content chocolate), may be helpful. 

If you are not sure whether caffeine might affect you, you might like to talk to your specialists about how to manage this.

Exercise

Exercise is often recommended for people with a heart condition, and moderate exercise can be important for people with some types of cardiomyopathy (depending on their symptoms). However, it can trigger arrhythmias and heart failure symptoms, and can be dangerous if the condition is unstable. Finding exercise that is helpful and suitable for you, needs to be carefully considered and individualised.

Read more detailed information about exercise.

© Cardiomyopathy UK. August 2017.