Heart failure (HF) is a leading cause of cardiovascular morbidity, mortality, and health care expenditure. Guideline-directed medical therapy and device-based therapy in HF are well established. However, the role of nonpharmacologic modalities to improve HF care remains underappreciated, is underused, and requires multimodal approaches to care. Diet, exercise and cardiac rehabilitation, sleep-disordered breathing, mood disorders, and substance use disorders are potential targets to reduce morbidity and improve function of patients with HF. Addressing these factors may improve symptoms and quality of life, reduce hospitalizations, and improve mortality in heart failure. This state-of-the-art review discusses dietary interventions, exercise programs, and the management of sleep-disordered breathing, mood disorders, and substance use in individuals with heart failure. The authors review the latest data and provide optimal lifestyle recommendations and recommended prescriptions for nonpharmacologic therapies.

Editors

JACC Heart Failure Editor-in-Chief
Biykem Bozkurt, MD, PhD, FACC 

Deputy Editor
Akshay S. Desai, MD, MPH 

JACC Heart Failure CME/MOC Editor
Kenneth A. Ellenbogen, MD

Author
Ravi Thakker, MD

Important Dates

Date of Release: February 3, 2025
Term of Approval/Date of CME/MOC Expiration: February 2, 2026