Table of ContentsView AllTable of ContentsLifestyle ManagementPrescriptionsSurgeries and Specialist-Driven Procedures
Table of ContentsView All
View All
Table of Contents
Lifestyle Management
Prescriptions
Surgeries and Specialist-Driven Procedures
Also Known AsClinicians prefer the termheart failure with preserved ejection fraction (HFpEF)to refer to diastolic heart failure, according to the American Heart Association (AHA).
Also Known As
Clinicians prefer the termheart failure with preserved ejection fraction (HFpEF)to refer to diastolic heart failure, according to the American Heart Association (AHA).
Verywell / Brianna Gilmartin
Even for people with diastolic dysfunction who take medication, lifestyle modifications are of paramount importance to managing the condition and preventing it from becoming worse.
Weight Loss
Excess body weight forces the heart to work harder than it should. It also can contribute totype 2 diabetes, which, along with being overweight or obese, can contribute to cardiac complications and diseases.
The Connections Between Heart Disease, Obesity, and Weight Loss
Exercise
It’s been known for some time that regular, moderate aerobic exercise can improve the diastolic function of the heart. This doesn’t mean it’s necessary to become a marathon runner. Aerobic exercise refers to any activity that raises the heart rate enough to help strengthen the heart muscle, which can include swimming, bicycling, and brisk walking.
The amount of exercise associated with improved heart health and function may also surprise you.
The federal guidelines for aerobic exercise recommend adults log at least 150 minutes of moderate activity per week to improve and maintain heart health. To lose weight, the guidelines advise getting twice that, or 300 minutes.
Exercise in the form of acardiac rehabilitationprogram is the only approach to managing diastolic dysfunction that has been clinically proven in studies to significantly improve quality of life.
If you have diastolic dysfunction, simple changes in what you eat each day can play a significant role in preventing the condition from progressing. The AHA lays out simple guidelines for choosing foods that can help improve your heart health.
EmphasizeA variety of fruits and vegetablesWhole grainsLow-fat dairy foodsSkinless poultryFish and seafoodNutsLegumesOlive, avocado, and other non-tropical vegetable oilsLimitSaturated fatTrans fatCholesterolSodiumRed meatFoods such as baked goods, candy, and other products sweetened with sugarSoda and other beverages sweetened with sugar
EmphasizeA variety of fruits and vegetablesWhole grainsLow-fat dairy foodsSkinless poultryFish and seafoodNutsLegumesOlive, avocado, and other non-tropical vegetable oils
A variety of fruits and vegetables
Whole grains
Low-fat dairy foods
Skinless poultry
Fish and seafood
Nuts
Legumes
Olive, avocado, and other non-tropical vegetable oils
LimitSaturated fatTrans fatCholesterolSodiumRed meatFoods such as baked goods, candy, and other products sweetened with sugarSoda and other beverages sweetened with sugar
Saturated fat
Trans fat
Cholesterol
Sodium
Red meat
Foods such as baked goods, candy, and other products sweetened with sugar
Soda and other beverages sweetened with sugar
The Mediterranean Diet is an example of an effective approach to eating that embraces the AHA’s recommendations and is easy to follow and stick with. It is based on the eating habits of people in countries of the Mediterranean region, especially Greece. There isresearchto show the Mediterranean diet may help reduce the risk of heart disease, cancer, diabetes, and other health concerns.
Lean Beef Can Be Part of a Heart-Healthy Mediterranean Diet, Study Shows
The AHA also advises limiting caffeine to no more than one to two cups per day.
Low-Sodium Diet
Lowering sodium intake is an especially important aspect of any heart-healthy diet, since as many as 50% of people who have diastolic dysfunction also have hypertension. Bringing elevated blood pressure down to normal levels can help to prevent diastolic dysfunction from progressing to heart failure.
What Is the DASH Diet?
Like the Mediterranean diet, the DASH diet emphasizes the importance of eating fruits and vegetables, whole grains, fish, poultry, legumes, and low- or non-fat dairy products every day.
Quitting Smoking
If you smoke, according to the AHA, every time you take a drag on a cigarette your heart rate speeds up and your blood pressure is elevated temporarily. At the same time, less oxygen-rich blood is flowing through your body. In addition, over time, smoking can cause “stickiness” in blood vessels, effectively slowing and diminishing blood flow.
There are many effective ways tokick the habit, from quitting cold turkey to relying on support from self-help groups or taking medication. Whichever approach works for you, as soon as you put out that final cigarette, your cardiovascular system will begin to heal.
Diabetes and the Mediterranean Style Diet
Limiting Alcohol
A drink equals:
If you have any form of heart disease, it is imperative to discuss whether it’s safe for you to drink alcohol with your healthcare provider. If you get the OK, stick with any limits on drinking they advise.
How Much Alcohol Can Cause Heart Problems?
Controlling Hypertension
Treatingdiastolic dysfunction can be a challenge. There are no medications that treat diastolic heart failure, with the possible exception of the diuretic drugspironolactone. That’s why the best approach is to treat the underlying issues that are causing diastolic heart failure (e.g., smoking, hypertension, coronary disease, obesity, etc.). For the most part, drugs prescribed for people with diastolic dysfunction are used not to directly treat the condition, but rather to mitigate symptoms.
Diuretics
For example, a 2014 study called the TOPCAT trial found spironolactone (CaroSpir, Aldactone) reduced the risk of hospitalization in people with diastolic heart failure. (The drug did not, however, lower the rate of death due to diastolic heart failure).
There are three classes of diuretics, each of which affects blood pressure differently (both directly and indirectly).
How Treating Hypertension Can Improve Diastolic Dysfunction
ACE (Angiotensin-Converting Enzyme) Inhibitors
There are many ACE inhibitors available in the United States, among them:
ACE Inhibitors vs. Beta Blockers: How Are They Different?
Calcium Channel Blockers
Calcium channel blockers often prescribed for hypertension are:
SGLT2 Inhibitors
Sodium-glucose co-transporter 2 (SGLT2) inhibitors, including Inpefa (sotagliflozin) and Jardiance (empagliflozin), are approved for treating type 2 diabetes and as well as approved and recommended for adults with heart failure (regardless of ejection fraction) to reduce the risk of cardiovascular death and hospitalization due to heart and blood vessel disease.
Diabetesandobesityare both tied to coronary artery disease and, in turn, diastolic dysfunction. In addition, people withtype 2 diabetesare two to four times more likely to develop heart failure than someone without diabetes, according to the American Heart Association.As a result, keeping weight and diabetes under control can help slow the progression of diastolic dysfunction—and reduce the risk of developing it in the first place.
Angiotensin II Receptor Blockers (ARBs)
Examples include:
Angiotensin-Receptor Neprilysin Inhibitors (ARNIs)
Entresto contains a combination of valsartan (an ARB inhibitor) and a new type of drug called sacubitril. Sacubitril is a neprilysin inhibitor, which causes an increase in levels of natriuretic peptides. This helps regulate blood pressure, along with salt and fluid levels.
How Coronary Artery Disease Is Treated
Sleep Apnea Treatment
Sleep apnea conditionsare common among people with diastolic dysfunction. The most effective treatment for sleep apnea is acontinuous positive airway pressure (CPAP) device. The CPAP mask fits over the nose and mouth and gently blows air into the airway to help keep it open during sleep.
Although it’s possible in some cases to purchase a CPAP machine over the counter, most often a prescription is required. In fact, this is ideal, because it means how the apparatus is used can be fine-tuned to meet a person’s specific needs. It’s also more likely insurance will cover a healthcare provider-prescribed CPAP machine.
How Sleep Apnea Is Treated
Diastolic dysfunction that does not respond to lifestyle changes and medication may require more aggressive—and sometimes invasive—treatment.
Cardioversion
Atrial fibrillation(AFib)—an abnormally fast and irregular heartbeat—is a common characteristic of diastolic dysfunction, and one that can cause heart palpitations, shortness of breath, and a tendency to become easily fatigued.More concerning, however, is that uncontrolled AFib in people with heart disease can lead to worseningheart failure.
Cardioversionrefers to any treatment targeted at bringing AFib under control. In acute cases, some medications can be used to do this, including flecainide, Corvert (ibutilide), Rhythmol (propafenone), and Tikosyn (dofetilide). However, most of these only work 50% to 60% of the time and can cause side effects.
For these reasons, most cardiologists prefer electrical cardioversion, which involves being placed into a light, anesthesia-induced sleep for a few minutes, during which time a quick and painless electrical discharge is administered to the chest with a set of paddles. The procedure is safe and almost always works.
Angioplasty
If necessary a mesh, tube-shaped device called a stent is left behind to serve as a “scaffold” to help support the wall of the artery and keep it open.
Also Known AsAngioplasty is sometimes referred to as percutaneous transluminal coronary angioplasty or percutaneous coronary intervention.
Angioplasty is sometimes referred to as percutaneous transluminal coronary angioplasty or percutaneous coronary intervention.
What to Know About Angioplasty
Bypass Surgery
Heart Failure Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
Email AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Sign Up
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.
A Word From Verywell
Diastolic dysfunction is a potentially serious diagnosis, but there are many ways in which you can prevent the condition from progressing or causing symptoms that affect your ability to function. Tweaks to your diet, an increase in your activity level, quitting smoking (if you use tobacco), and cutting back on alcohol if your intake is beyond moderate are all straightforward and effective changes that are within your control. These lifestyle modifications are guaranteed to lower your risk of other chronic conditions. Even if you need medication or a surgical procedure, continuing to watch your diet, exercising, and making other healthy changes will allow you to feel better overall and enjoy living your best life.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kazik A, Wilczek K, Poloński L.Management of diastolic heart failure.Cardiol J. 2010;17(6):558-565.American Heart Association.Left-sided heart failure.Zamora E, Díez‐López C, Lupón J, et al.Weight loss in obese patients with heart failure.JAHA. 2016;5(3):e002468. doi:10.1161/JAHA.115.002468National Institute of Diabetes and Digestive and Kidney Diseases.Health risks of overweight & obesity.Department of Health and Human Services.Physical activity guidelines for Americans, 2nd edition.Van Craenenbroeck E.Exercise training as therapy for chronic heart failure.E J Cardiol Pract.2017;14(43).Tong TYN, Wareham NJ, Khaw K. et al.Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: The EPIC-Norfolk study.BMC Med.2016:14(1):135. doi:10.1186/s12916-016-0677-4Nazário Leão R, Marques da Silvabc P.Diastolic dysfunction in hypertension.Hipertens Riesgo Vasc. 2017;34(3):128-139. doi:10.1016/j.hipert.2017.01.001American Cancer Society.Health benefits of quitting smoking over time.Centers for Disease Control and Prevention.Managing high blood pressure.Harvard Health Publishing.Diastolic heart failure.Pitt B, Pfeffer MA, Assmann SF, et al.Spironolactone for heart failure with preserved ejection fraction.N Engl J Med. 2014;370(15):1383-92. doi:10.1056/NEJMoa1313731British Heart Foundation.What are ACE inhibitors and what do they do in your body?Ginelli P, Bella JN.Treatment of diastolic dysfunction in hypertension.Nutr Metab Cardiovasc Dis. 2012;22(8):613-618. doi:10.1016/j.numecd.2012.04.016Heidenreich P, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA guideline for the management of heart failure.J Am Coll Cardiol. 2022;79(17):e263–e421. doi:10.1016/j.jacc.2021.12.012Boehringer Ingelheim.Jardiance.American Heart Association.Diabetes and heart failure are linked; treatment should be too.Yandrapalli S, Khan MH, Rochlani Y, Aronow WS.Sacubitril/valsartan in cardiovascular disease: Evidence to date and place in therapy.Ther Adv Cardiovasc Dis. 2018;12(8):217-231. doi:10.1177/1753944718784536Baguet JP, Barone-Rochette G, Lévy P, et al.Left ventricular diastolic dysfunction is linked to severity of obstructive sleep apnoea.Eur Respir J. 2010;36(6):1323-9. doi:10.1183/09031936.00165709Rosenberg M, Warren J, Manning W.Diastolic dysfunction and risk of atrial fibrillation: A mechanistic appraisal.Circulation. 2012;126(19):2353–2362. doi:10.1161/CIRCULATIONAHA.112.113233American Heart Association.What is atrial fibrillation (AFib or AF)?Additional ReadingAmerican Heart Association.Lifestyle changes for heart failure.Borlaug BA, Paulus WJ.Heart failure with preserved ejection fraction: Pathophysiology, diagnosis, and treatment.Eur Heart J. 2011;32:670. doi:10.1093/eurheartj/ehq426
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kazik A, Wilczek K, Poloński L.Management of diastolic heart failure.Cardiol J. 2010;17(6):558-565.American Heart Association.Left-sided heart failure.Zamora E, Díez‐López C, Lupón J, et al.Weight loss in obese patients with heart failure.JAHA. 2016;5(3):e002468. doi:10.1161/JAHA.115.002468National Institute of Diabetes and Digestive and Kidney Diseases.Health risks of overweight & obesity.Department of Health and Human Services.Physical activity guidelines for Americans, 2nd edition.Van Craenenbroeck E.Exercise training as therapy for chronic heart failure.E J Cardiol Pract.2017;14(43).Tong TYN, Wareham NJ, Khaw K. et al.Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: The EPIC-Norfolk study.BMC Med.2016:14(1):135. doi:10.1186/s12916-016-0677-4Nazário Leão R, Marques da Silvabc P.Diastolic dysfunction in hypertension.Hipertens Riesgo Vasc. 2017;34(3):128-139. doi:10.1016/j.hipert.2017.01.001American Cancer Society.Health benefits of quitting smoking over time.Centers for Disease Control and Prevention.Managing high blood pressure.Harvard Health Publishing.Diastolic heart failure.Pitt B, Pfeffer MA, Assmann SF, et al.Spironolactone for heart failure with preserved ejection fraction.N Engl J Med. 2014;370(15):1383-92. doi:10.1056/NEJMoa1313731British Heart Foundation.What are ACE inhibitors and what do they do in your body?Ginelli P, Bella JN.Treatment of diastolic dysfunction in hypertension.Nutr Metab Cardiovasc Dis. 2012;22(8):613-618. doi:10.1016/j.numecd.2012.04.016Heidenreich P, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA guideline for the management of heart failure.J Am Coll Cardiol. 2022;79(17):e263–e421. doi:10.1016/j.jacc.2021.12.012Boehringer Ingelheim.Jardiance.American Heart Association.Diabetes and heart failure are linked; treatment should be too.Yandrapalli S, Khan MH, Rochlani Y, Aronow WS.Sacubitril/valsartan in cardiovascular disease: Evidence to date and place in therapy.Ther Adv Cardiovasc Dis. 2018;12(8):217-231. doi:10.1177/1753944718784536Baguet JP, Barone-Rochette G, Lévy P, et al.Left ventricular diastolic dysfunction is linked to severity of obstructive sleep apnoea.Eur Respir J. 2010;36(6):1323-9. doi:10.1183/09031936.00165709Rosenberg M, Warren J, Manning W.Diastolic dysfunction and risk of atrial fibrillation: A mechanistic appraisal.Circulation. 2012;126(19):2353–2362. doi:10.1161/CIRCULATIONAHA.112.113233American Heart Association.What is atrial fibrillation (AFib or AF)?Additional ReadingAmerican Heart Association.Lifestyle changes for heart failure.Borlaug BA, Paulus WJ.Heart failure with preserved ejection fraction: Pathophysiology, diagnosis, and treatment.Eur Heart J. 2011;32:670. doi:10.1093/eurheartj/ehq426
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kazik A, Wilczek K, Poloński L.Management of diastolic heart failure.Cardiol J. 2010;17(6):558-565.American Heart Association.Left-sided heart failure.Zamora E, Díez‐López C, Lupón J, et al.Weight loss in obese patients with heart failure.JAHA. 2016;5(3):e002468. doi:10.1161/JAHA.115.002468National Institute of Diabetes and Digestive and Kidney Diseases.Health risks of overweight & obesity.Department of Health and Human Services.Physical activity guidelines for Americans, 2nd edition.Van Craenenbroeck E.Exercise training as therapy for chronic heart failure.E J Cardiol Pract.2017;14(43).Tong TYN, Wareham NJ, Khaw K. et al.Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: The EPIC-Norfolk study.BMC Med.2016:14(1):135. doi:10.1186/s12916-016-0677-4Nazário Leão R, Marques da Silvabc P.Diastolic dysfunction in hypertension.Hipertens Riesgo Vasc. 2017;34(3):128-139. doi:10.1016/j.hipert.2017.01.001American Cancer Society.Health benefits of quitting smoking over time.Centers for Disease Control and Prevention.Managing high blood pressure.Harvard Health Publishing.Diastolic heart failure.Pitt B, Pfeffer MA, Assmann SF, et al.Spironolactone for heart failure with preserved ejection fraction.N Engl J Med. 2014;370(15):1383-92. doi:10.1056/NEJMoa1313731British Heart Foundation.What are ACE inhibitors and what do they do in your body?Ginelli P, Bella JN.Treatment of diastolic dysfunction in hypertension.Nutr Metab Cardiovasc Dis. 2012;22(8):613-618. doi:10.1016/j.numecd.2012.04.016Heidenreich P, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA guideline for the management of heart failure.J Am Coll Cardiol. 2022;79(17):e263–e421. doi:10.1016/j.jacc.2021.12.012Boehringer Ingelheim.Jardiance.American Heart Association.Diabetes and heart failure are linked; treatment should be too.Yandrapalli S, Khan MH, Rochlani Y, Aronow WS.Sacubitril/valsartan in cardiovascular disease: Evidence to date and place in therapy.Ther Adv Cardiovasc Dis. 2018;12(8):217-231. doi:10.1177/1753944718784536Baguet JP, Barone-Rochette G, Lévy P, et al.Left ventricular diastolic dysfunction is linked to severity of obstructive sleep apnoea.Eur Respir J. 2010;36(6):1323-9. doi:10.1183/09031936.00165709Rosenberg M, Warren J, Manning W.Diastolic dysfunction and risk of atrial fibrillation: A mechanistic appraisal.Circulation. 2012;126(19):2353–2362. doi:10.1161/CIRCULATIONAHA.112.113233American Heart Association.What is atrial fibrillation (AFib or AF)?
Kazik A, Wilczek K, Poloński L.Management of diastolic heart failure.Cardiol J. 2010;17(6):558-565.
American Heart Association.Left-sided heart failure.
Zamora E, Díez‐López C, Lupón J, et al.Weight loss in obese patients with heart failure.JAHA. 2016;5(3):e002468. doi:10.1161/JAHA.115.002468
National Institute of Diabetes and Digestive and Kidney Diseases.Health risks of overweight & obesity.
Department of Health and Human Services.Physical activity guidelines for Americans, 2nd edition.
Van Craenenbroeck E.Exercise training as therapy for chronic heart failure.E J Cardiol Pract.2017;14(43).
Tong TYN, Wareham NJ, Khaw K. et al.Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: The EPIC-Norfolk study.BMC Med.2016:14(1):135. doi:10.1186/s12916-016-0677-4
Nazário Leão R, Marques da Silvabc P.Diastolic dysfunction in hypertension.Hipertens Riesgo Vasc. 2017;34(3):128-139. doi:10.1016/j.hipert.2017.01.001
American Cancer Society.Health benefits of quitting smoking over time.
Centers for Disease Control and Prevention.Managing high blood pressure.
Harvard Health Publishing.Diastolic heart failure.
Pitt B, Pfeffer MA, Assmann SF, et al.Spironolactone for heart failure with preserved ejection fraction.N Engl J Med. 2014;370(15):1383-92. doi:10.1056/NEJMoa1313731
British Heart Foundation.What are ACE inhibitors and what do they do in your body?
Ginelli P, Bella JN.Treatment of diastolic dysfunction in hypertension.Nutr Metab Cardiovasc Dis. 2012;22(8):613-618. doi:10.1016/j.numecd.2012.04.016
Heidenreich P, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA guideline for the management of heart failure.J Am Coll Cardiol. 2022;79(17):e263–e421. doi:10.1016/j.jacc.2021.12.012
Boehringer Ingelheim.Jardiance.
American Heart Association.Diabetes and heart failure are linked; treatment should be too.
Yandrapalli S, Khan MH, Rochlani Y, Aronow WS.Sacubitril/valsartan in cardiovascular disease: Evidence to date and place in therapy.Ther Adv Cardiovasc Dis. 2018;12(8):217-231. doi:10.1177/1753944718784536
Baguet JP, Barone-Rochette G, Lévy P, et al.Left ventricular diastolic dysfunction is linked to severity of obstructive sleep apnoea.Eur Respir J. 2010;36(6):1323-9. doi:10.1183/09031936.00165709
Rosenberg M, Warren J, Manning W.Diastolic dysfunction and risk of atrial fibrillation: A mechanistic appraisal.Circulation. 2012;126(19):2353–2362. doi:10.1161/CIRCULATIONAHA.112.113233
American Heart Association.What is atrial fibrillation (AFib or AF)?
American Heart Association.Lifestyle changes for heart failure.Borlaug BA, Paulus WJ.Heart failure with preserved ejection fraction: Pathophysiology, diagnosis, and treatment.Eur Heart J. 2011;32:670. doi:10.1093/eurheartj/ehq426
American Heart Association.Lifestyle changes for heart failure.
Borlaug BA, Paulus WJ.Heart failure with preserved ejection fraction: Pathophysiology, diagnosis, and treatment.Eur Heart J. 2011;32:670. doi:10.1093/eurheartj/ehq426
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.Cookies SettingsAccept All Cookies
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
Cookies SettingsAccept All Cookies
