Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology

Tiny Jaarsma, Loreena Hill, Antoni Bayes-Genis, Hans-Peter Brunner La Rocca, Teresa Castiello, Jelena Čelutkienė, Elena Marques-Sule, Carla M Plymen, Susan E Piper, Barbara Riegel, Frans H Rutten, Tuvia Ben Gal, Johann Bauersachs, Andrew J S Coats, Ovidiu Chioncel, Yuri Lopatin, Lars H Lund, Mitja Lainscak, Brenda Moura, Wilfried Mullens, Massimo F Piepoli, Giuseppe Rosano, Petar Seferovic, Anna Strömberg, Tiny Jaarsma, Loreena Hill, Antoni Bayes-Genis, Hans-Peter Brunner La Rocca, Teresa Castiello, Jelena Čelutkienė, Elena Marques-Sule, Carla M Plymen, Susan E Piper, Barbara Riegel, Frans H Rutten, Tuvia Ben Gal, Johann Bauersachs, Andrew J S Coats, Ovidiu Chioncel, Yuri Lopatin, Lars H Lund, Mitja Lainscak, Brenda Moura, Wilfried Mullens, Massimo F Piepoli, Giuseppe Rosano, Petar Seferovic, Anna Strömberg

Abstract

Self-care is essential in the long-term management of chronic heart failure. Heart failure guidelines stress the importance of patient education on treatment adherence, lifestyle changes, symptom monitoring and adequate response to possible deterioration. Self-care is related to medical and person-centred outcomes in patients with heart failure such as better quality of life as well as lower mortality and readmission rates. Although guidelines give general direction for self-care advice, health care professionals working with patients with heart failure need more specific recommendations. The aim of the management recommendations in this paper is to provide practical advice for health professionals delivering care to patients with heart failure. Recommendations for nutrition, physical activity, medication adherence, psychological status, sleep, leisure and travel, smoking, immunization and preventing infections, symptom monitoring, and symptom management are consistent with information from guidelines, expert consensus documents, recent evidence and expert opinion.

Keywords: Heart failure; Lifestyle; Patient education; Self-care.

© 2020 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Figures

Figure 1
Figure 1
Self‐care is an overarching concept based on three key concepts: (i) self‐care maintenance (e.g. taking medication as prescribed, physical activity), (ii) self‐care monitoring (e.g regular weighing), and (iii) self‐care management (e.g. changing diuretic dose in response to symptoms).
Figure 2
Figure 2
Guidance for self‐care monitoring and self‐care management of patients with heart failure (HF). GP, general practitioner.

References

    1. Riegel B, Jaarsma T, Stromberg A. A middle‐range theory of self‐care of chronic illness. ANS Adv Nurs Sci 2012;35:194–204.
    1. Lee CS, Bidwell JT, Paturzo M, Alvaro R, Cocchieri A, Jaarsma T, Strömberg A, Riegel B, Vellone E. Patterns of self‐care and clinical events in a cohort of adults with heart failure: 1 year follow‐up. Heart Lung 2018;47:40–46.
    1. Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, Grady KL, Gurvitz MZ, Havranek EP, Lee CS, Lindenfeld J, Peterson PN, Pressler SJ, Schocken DD, Whellan DJ; American Heart Association Council on Cardiovascular Nursing, American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research . State of the science: promoting self‐care in persons with heart failure: a scientific statement from the American Heart Association. Circulation 2009;120:1141–1163.
    1. McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol 2004;44:810–819.
    1. Riegel B, Dunbar SB, Fitzsimons D, Freedland KE, Lee CS, Middleton S, Stromberg A, Vellone E, Webber DE, Jaarsma T. Self‐care research: where are we now? Where are we going? Int J Nurs Stud 2019:103402.
    1. Lainscak M, Blue L, Clark AL, Dahlström U, Dickstein K, Ekman I, McDonagh T, McMurray JJ, Ryder M, Stewart S, Strömberg A, Jaarsma T. Self‐care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2011;13:115–126.
    1. Mahajan R, Stokes M, Elliott A, Munawar DA, Khokhar KB, Thiyagarajah A, Hendriks J, Linz D, Gallagher C, Kaye D, Lau D, Sanders P. Complex interaction of obesity, intentional weight loss and heart failure: a systematic review and meta‐analysis. Heart 2020;106:58–68.
    1. Obokata M, Reddy YN, Pislaru SV, Melenovsky V, Borlaug BA. Evidence supporting the existence of a distinct obese phenotype of heart failure with preserved ejection fraction. Circulation 2017;136:6–19.
    1. Valentova M, von Haehling S, Bauditz J, Doehner W, Ebner N, Bekfani T, Elsner S, Sliziuk V, Scherbakov N, Murín J, Anker SD, Sandek A. Intestinal congestion and right ventricular dysfunction: a link with appetite loss, inflammation, and cachexia in chronic heart failure. Eur Heart J 2016;37:1684–1691.
    1. Vest AR, Chan M, Deswal A, Givertz MM, Lekavich C, Lennie T, Litwin SE, Parsly L, Rodgers JE, Rich MW, Schulze PC, Slader A, Desai A. Nutrition, obesity, and cachexia in patients with heart failure: a consensus statement from the Heart Failure Society of America Scientific Statements Committee. J Card Fail 2019;25:380–400.
    1. Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary behavior, exercise, and cardiovascular health. Circ Res 2019;124:799–815.
    1. Nagarajan V, Cauthen CA, Starling RC, Tang WH. Prognosis of morbid obesity patients with advanced heart failure. Congest Heart Fail 2013;19:160–164.
    1. Evans WJ, Morley JE, Argiles J, Bales C, Baracos V, Guttridge D, Jatoi A, Kalantar‐Zadeh K, Lochs H, Mantovani G, Marks D, Mitch WE, Muscaritoli M, Najand A, Ponikowski P, Rossi Fanelli F, Schambelan M, Schols A, Schuster M, Thomas D, Wolfe R, Anker SD. Cachexia: a new definition. Clin Nutr 2008;27:793–799.
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, González‐Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2016;18:891–975.
    1. Yancy CW, Januzzi JL Jr, Allen LA, Butler J, Davis LL, Fonarow GC, Ibrahim NE, Jessup M, Lindenfeld J, Maddox TM, Masoudi FA, Motiwala SR, Patterson JH, Walsh MN, Wasserman A. 2017 ACC expert consensus decision pathway for optimization of heart failure treatment: answers to 10 pivotal issues about heart failure with reduced ejection fraction: a report of the American College of Cardiology Task Force on expert consensus decision pathways. J Am Coll Cardiol 2018;71:201–230.
    1. Johansson P, van der Wal MH, Stromberg A, Waldreus N, Jaarsma T. Fluid restriction in patients with heart failure: how should we think? Eur J Cardiovasc Nurs 2016;15:301–304.
    1. Castro‐Gutiérrez V, Rada G. Is fluid restriction needed in heart failure? Medwave 2017;17(Suppl 1):e6817.
    1. Dunlap ME, Hauptman PJ, Amin AN, Chase SL, Chiodo JA 3rd, Chiong JR, Dasta JF. Current management of hyponatremia in acute heart failure: a report from the hyponatremia registry for patients with euvolemic and hypervolemic hyponatremia (HN registry). J Am Heart Assoc 2017;6:e005261.
    1. Song EK, Moser DK, Kang SM, Lennie TA. Self‐reported adherence to a low‐sodium diet and health outcomes in patients with heart failure. J Cardiovasc Nurs 2016;31:529–534.
    1. Lennie TA, Song EK, Wu JR, Chung ML, Dunbar SB, Pressler SJ, Moser DK. Three gram sodium intake is associated with longer event‐free survival only in patients with advanced heart failure. J Card Fail 2011;17:325–330.
    1. Doukky R, Avery E, Mangla A, Collado FM, Ibrahim Z, Poulin MF, Richardson DJ, Powell LH. Impact of dietary sodium restriction on heart failure outcomes. JACC Heart Fail 2016;4:24–35.
    1. Mahtani KR, Heneghan C, Onakpoya I, Tierney S, Aronson JK, Roberts N, Hobbs FD, Nunan D. Reduced salt intake for heart failure: a systematic review. JAMA Intern Med 2018;178:1693–1700.
    1. Piepoli MF, Abreu A, Albus C, Ambrosetti M, Brotons C, Catapano AL, Corra U, Cosyns B, Deaton C, Graham I, Hoes A, Lochen ML, Matrone B, Redon J, Sattar N, Smulders Y, Tiberi M. Update on cardiovascular prevention in clinical practice: a position paper of the European Association of Preventive Cardiology of the European Society of Cardiology. Eur J Prev Cardiol 2020;27:181–205.
    1. Klatsky AL. Alcohol and cardiovascular diseases: where do we stand today? J Intern Med 2015;278:238–250.
    1. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;128:e240–327.
    1. Seferovic PM, Ponikowski P, Anker SD, Bauersachs J, Chioncel O, Cleland JG, de Boer RA, Drexel H, Ben Gal T, Hill L, Jaarsma T, Jankowska EA, Anker MS, Lainscak M, Lewis BS, McDonagh T, Metra M, Milicic D, Mullens W, Piepoli MF, Rosano G, Ruschitzka F, Volterrani M, Voors AA, Filippatos G, Coats AJ. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2019;21:1169–1186.
    1. Jankowska EA, Tkaczyszyn M, Suchocki T, Drozd M, von Haehling S, Doehner W, Banasiak W, Filippatos G, Anker SD, Ponikowski P. Effects of intravenous iron therapy in iron‐deficient patients with systolic heart failure: a meta‐analysis of randomized controlled trials. Eur J Heart Fail 2016;18:786–795.
    1. Zhang S, Zhang F, Du M, Huang K, Wang C. Efficacy and safety of iron supplementation in patients with heart failure and iron deficiency: a meta‐analysis. Br J Nutr 2019;121:841–848.
    1. Mordi IR, Tee A, Lang CC. Iron therapy in heart failure: ready for primetime? Card Fail Rev 2018;4:28–32.
    1. Lewis GD, Malhotra R, Hernandez AF, McNulty SE, Smith A, Felker GM, Tang WH, LaRue SJ, Redfield MM, Semigran MJ, Givertz MM, van Buren P, Whellan D, Anstrom KJ, Shah MR, Desvigne‐Nickens P, Butler J, Braunwald E; NHLBI Heart Failure Clinical Research Network . Effect of oral iron repletion on exercise capacity in patients with heart failure with reduced ejection fraction and iron deficiency: the IRONOUT HF randomized clinical trial. JAMA 2017;317:1958–1966.
    1. Rosano GM, Tamargo J, Kjeldsen KP, Lainscak M, Agewall S, Anker SD, Ceconi C, Coats AJ, Drexel H, Filippatos G, Kaski JC, Lund L, Niessner A, Ponikowski P, Savarese G, Schmidt TA, Seferovic P, Wassmann S, Walther T, Lewis BS. Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors: coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology. Eur Heart J Cardiovasc Pharmacother 2018;4:180–188.
    1. Cvetinovic N, Loncar G, Isakovic AM, von Haehling S, Doehner W, Lainscak M, Farkas J. Micronutrient depletion in heart failure: common, clinically relevant and treatable. Int J Mol Sci 2019;20:5627.
    1. Fotino AD, Thompson‐Paul AM, Bazzano LA. Effect of coenzyme Q(1)(0) supplementation on heart failure: a meta‐analysis. Am J Clin Nutr 2013;97:268–275.
    1. Lei L, Liu Y. Efficacy of coenzyme Q10 in patients with cardiac failure: a meta‐analysis of clinical trials. BMC Cardiovasc Disord 2017;17:196.
    1. Argilés JM, Muscaritoli M. Unifying diagnostic criteria for cachexia: an urgent need. Clin Nutr 2017;36:910–911.
    1. Piepoli MF, Davos C, Francis DP, Coats AJ. Exercise training meta‐analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004;328:189.
    1. Conraads VM, Deaton C, Piotrowicz E, Santaularia N, Tierney S, Piepoli MF, Pieske B, Schmid JP, Dickstein K, Ponikowski PP, Jaarsma T. Adherence of heart failure patients to exercise: barriers and possible solutions: a position statement of the Study Group on Exercise Training in Heart Failure of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2012;14:451–458.
    1. Dhutia H, Sharma S. Playing it safe: exercise and cardiovascular health. Practitioner 2015;259:15–20, 2.
    1. Levine GN, Steinke EE, Bakaeen FG, Bozkurt B, Cheitlin MD, Conti JB, Foster E, Jaarsma T, Kloner RA, Lange RA, Lindau ST, Maron BJ, Moser DK, Ohman EM, Seftel AD, Stewart WJ; American Heart Association Council on Clinical Cardiology; Council on Cardiovascular Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Quality of Care and Outcomes Research . Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2012;125:1058–1072.
    1. Piepoli MF, Conraads V, Corrà U, Dickstein K, Francis DP, Jaarsma T, McMurray J, Pieske B, Piotrowicz E, Schmid JP, Anker SD, Solal AC, Filippatos GS, Hoes AW, Gielen S, Giannuzzi P, Ponikowski PP. Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail 2011;13:347–357.
    1. Hansen D, Rovelo Ruiz G, Doherty P, Iliou MC, Vromen T, Hinton S, Frederix I, Wilhelm M, Schmid JP, Abreu A, Ambrosetti M, Garcia‐Porrero E, Coninx K, Dendale P; EAPC EXPERT Working Group . Do clinicians prescribe exercise similarly in patients with different cardiovascular diseases? Findings from the EAPC EXPERT Working Group survey. Eur J Prev Cardiol 2018;25:682–691.
    1. Gast A, Mathes T. Medication adherence influencing factors‐an (updated) overview of systematic reviews. Syst Rev 2019;8:112.
    1. Fitzgerald AA, Powers JD, Ho PM, Maddox TM, Peterson PN, Allen LA, Masoudi FA, Magid DJ, Havranek EP. Impact of medication nonadherence on hospitalizations and mortality in heart failure. J Card Fail 2011;17:664–669.
    1. Vitale C, Jankowska E, Hill L, Piepoli M, Doehner W, Anker SD, Lainscak M, Jaarsma T, Ponikowski P, Rosano GM, Seferovic P, Coats AJ. Heart Failure Association/European Society of Cardiology position paper on frailty in patients with heart failure. Eur J Heart Fail 2019;21:1299–1305.
    1. Leslie KH, McCowan C, Pell JP. Adherence to cardiovascular medication: a review of systematic reviews. J Public Health (Oxf) 2019;41:e84–94.
    1. Kim J, Hwang SY, Heo S, Shin MS, Kim SH. Predicted relationships between cognitive function, depressive symptoms, self‐care adequacy, and health‐related quality of life and major events among patients with heart failure. Eur J Cardiovasc Nurs 2019;18:418–426.
    1. Buck HG, Stromberg A, Chung ML, Donovan KA, Harkness K, Howard AM, Kato N, Polo R, Evangelista LS. A systematic review of heart failure dyadic self‐care interventions focusing on intervention components, contexts, and outcomes. Int J Nurs Stud 2018;77:232–242.
    1. Hooker SA, Schmiege SJ, Trivedi RB, Amoyal NR, Bekelman DB. Mutuality and heart failure self‐care in patients and their informal caregivers. Eur J Cardiovasc Nurs 2018;17:102–113.
    1. Oosterom‐Calo R, van Ballegooijen AJ, Terwee CB, te Velde SJ, Brouwer IA, Jaarsma T, Brug J. Determinants of adherence to heart failure medication: a systematic literature review. Heart Fail Rev 2013;18:409–427.
    1. Wu JR, Frazier SK, Rayens MK, Lennie TA, Chung ML, Moser DK. Medication adherence, social support, and event‐free survival in patients with heart failure. Health Psychol 2013;32:637–646.
    1. Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J 2014;35:1365–1372.
    1. Müller‐Tasch T, Löwe B, Lossnitzer N, Frankenstein L, Täger T, Haass M, Katus H, Schultz JH, Herzog W. Anxiety and self‐care behaviour in patients with chronic systolic heart failure: a multivariate model. Eur J Cardiovasc Nurs 2018;17:170–177.
    1. Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo‐Leiro MG, Harjola VP, Parissis J, Laroche C, Piepoli MF, Fonseca C, Mebazaa A, Lund L, Ambrosio GA, Coats AJ, Ferrari R, Ruschitzka F, Maggioni AP, Filippatos G. Epidemiology and one‐year outcomes in patients with chronic heart failure and preserved, mid‐range and reduced ejection fraction: an analysis of the ESC Heart Failure Long‐Term Registry. Eur J Heart Fail 2017;19:1574–1585.
    1. Biddle MJ, Moser DK, Pelter MM, Robinson S, Dracup K. Predictors of adherence to self‐care in rural patients with heart failure. J Rural Health 2020;36:120–129.
    1. Tu RH, Zeng ZY, Zhong GQ, Wu WF, Lu YJ, Bo ZD, He Y, Huang WQ, Yao LM. Effects of exercise training on depression in patients with heart failure: a systematic review and meta‐analysis of randomized controlled trials. Eur J Heart Fail 2014;16:749–757.
    1. Rajeswaran T, Plymen CM, Doherty AM. The effect of antidepressant medications in the management of heart failure on outcomes: mortality, cardiovascular function and depression – a systematic review. Int J Psychiatry Clin Pract 2018;22:164–169.
    1. Sbolli M, Fiuzat M, Cani D, O'Connor CM. Depression and heart failure: the lonely comorbidity. Eur J Heart Fail 2020;22:2007–2017.
    1. Gok Metin Z, Ejem D, Dionne‐Odom JN, Turkman Y, Salvador C, Pamboukian S, Bakitas M. Mind‐body interventions for individuals with heart failure: a systematic review of randomized trials. J Card Fail 2018;24:186–201.
    1. Norman J, Fu M, Ekman I, Björck L, Falk K. Effects of a mindfulness‐based intervention on symptoms and signs in chronic heart failure: a feasibility study. Eur J Cardiovasc Nurs 2018;17:54–65.
    1. Viveiros J, Chamberlain B, O'Hare A, Sethares KA. Meditation interventions among heart failure patients: an integrative review. Eur J Cardiovasc Nurs 2019;18:720–728.
    1. Peng Y, Fang J, Huang W, Qin S. Efficacy of cognitive behavioral therapy for heart failure. Int Heart J 2019;60:665–670.
    1. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self‐care in heart failure patients: a randomized clinical trial. JAMA Intern Med 2015;175:1773–1782.
    1. Pattenden JF, Roberts H, Lewin RJ. Living with heart failure; patient and carer perspectives. Eur J Cardiovasc Nurs 2007;6:273–279.
    1. Buck HG, Harkness K, Wion R, Carroll SL, Cosman T, Kaasalainen S, Kryworuchko J, McGillion M, O'Keefe‐McCarthy S, Sherifali D, Strachan PH, Arthur HM. Caregivers' contributions to heart failure self‐care: a systematic review. Eur J Cardiovasc Nurs 2015;14:79–89.
    1. Pearse SG, Cowie MR. Sleep‐disordered breathing in heart failure. Eur J Heart Fail 2016;18:353–361.
    1. Gau FY, Chen XP, Wu HY, Lin ML, Chao YF. Sleep‐related predictors of quality of life in the elderly versus younger heart failure patients: a questionnaire survey. Int J Nurs Stud 2011;48:419–428.
    1. Jeon S, Redeker NS. Sleep disturbance, daytime symptoms, and functional performance in patients with stable heart failure: a mediation analysis. Nurs Res 2016;65:259–267.
    1. Al‐Rawashdeh SY, Lennie TA, Chung ML. The association of sleep disturbances with quality of life in heart failure patient‐caregiver dyads. West J Nurs Res 2017;39:492–506.
    1. Spedale V, Luciani M, Attanasio A, Di Mauro S, Alvaro R, Vellone E, Ausili D. Association between sleep quality and self‐care in adults with heart failure: a systematic review. Eur J Cardiovasc Nurs 2020. Jul 16. 10.1177/1474515120941368 [Epub ahead of print].
    1. Ryou C, Kang SM, Jang Y. Factors associated with self‐care behaviours among Koreans with heart failure. Eur J Cardiovasc Nurs 2020. Jun 15. 10.1177/1474515120934060 [Epub ahead of print].
    1. Cowie MR, Woehrle H, Wegscheider K, Angermann C, d'Ortho MP, Erdmann E, Levy P, Simonds AK, Somers VK, Zannad F, Teschler H. Adaptive servo‐ventilation for central sleep apnea in systolic heart failure. N Engl J Med 2015;373:1095–1105.
    1. Cowie MR, Gallagher AM, Simonds AK. Treating central sleep apnoea in heart failure: is pull better than push? Eur J Heart Fail 2018;20:1755–1759.
    1. Pak VM, Strouss L, Yaggi HK, Redeker NS, Mohsenin V, Riegel B. Mechanisms of reduced sleepiness symptoms in heart failure and obstructive sleep apnea. J Sleep Res 2019;28:e12778.
    1. Sato Y, Yoshihisa A, Hotsuki Y, Watanabe K, Kimishima Y, Kiko T, Kanno Y, Yokokawa T, Abe S, Misaka T, Sato T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y. Associations of benzodiazepine with adverse prognosis in heart failure patients with insomnia. J Am Heart Assoc 2020;9:e013982.
    1. Manolis TA, Manolis AA, Apostolopoulos E, Melita H, Manolis AS. Cardiovascular complications of sleep disorders: a better night's sleep for a healthier heart/from bench to bedside. Curr Vasc Pharmacol 2021;19:210–232.
    1. Leon MN, Lateef M, Fuentes F. Prevention and management of cardiovascular events during travel. J Travel Med 1996;3:227–230.
    1. Peterson DC, Martin‐Gill C, Guyette FX, Tobias AZ, McCarthy CE, Harrington ST, Delbridge TR, Yealy DM. Outcomes of medical emergencies on commercial airline flights. N Engl J Med 2013;368:2075–2083.
    1. Novaro GM, Bush HS, Fromkin KR, Shen MY, Helguera M, Pinski SL, Asher CR. Cardiovascular emergencies in cruise ship passengers. Am J Cardiol 2010;105:153–157.
    1. Smith D, Toff W, Joy M, Dowdall N, Johnston R, Clark L, Gibbs S, Boon N, Hackett D, Aps C, Anderson M, Cleland J. Fitness to fly for passengers with cardiovascular disease. Heart 2010;96 Suppl 2:ii1–16.
    1. Trujillo‐Santos AJ, Jimenez‐Puente A, Perea‐Milla E. Association between long travel and venous thromboembolic disease: a systematic review and meta‐analysis of case‐control studies. Ann Hematol 2008;87:79–86.
    1. Hobkirk JP, Damy T, Walters M, Bennett A, Smith SJ, Ingle L, Clark AL, Cleland JG. Effects of reducing inspired oxygen concentration for one hour in patients with chronic heart failure: implications for air travel. Eur J Heart Fail 2013;15:505–510.
    1. Ingle L, Hobkirk J, Damy T, Nabb S, Clark AL, Cleland JG. Experiences of air travel in patients with chronic heart failure. Int J Cardiol 2012;158:66–70.
    1. Agostoni P, Cattadori G, Guazzi M, Bussotti M, Conca C, Lomanto M, Marenzi G, Guazzi MD. Effects of simulated altitude‐induced hypoxia on exercise capacity in patients with chronic heart failure. Am J Med 2000;109:450–455.
    1. Grun GH, Luks N Malone‐Lee J Trimmel M Schreiber R Mellert V, Kos J, Hofbauer W. Impact of Cabin Pressure on Aspects of the Well‐Being of Aircraft Passengers – A Laboratory Study. 26th International Congress of the Aeronautical Sciences 2008. (22 September 2020).
    1. Hammadah M, Kindya BR, Allard‐Ratick MP, Jazbeh S, Eapen D, Wilson Tang WH, Sperling L. Navigating air travel and cardiovascular concerns: is the sky the limit? Clin Cardiol 2017;40:660–666.
    1. Parati G, Agostoni P, Basnyat B, Bilo G, Brugger H, Coca A, Festi L, Giardini G, Lironcurti A, Luks AM, Maggiorini M, Modesti PA, Swenson ER, Williams B, Bärtsch P, Torlasco C. Clinical recommendations for high altitude exposure of individuals with pre‐existing cardiovascular conditions: a joint statement by the European Society of Cardiology, the Council on Hypertension of the European Society of Cardiology, the European Society of Hypertension, the International Society of Mountain Medicine, the Italian Society of Hypertension and the Italian Society of Mountain Medicine. Eur Heart J 2018;39:1546–1554.
    1. García Lledó A, Valdés Rodríguez E, Ozcoidi Val M. Heart disease and vehicle driving: novelties in European and Spanish law. Rev Esp Cardiol 2018;71:892–894.
    1. Vijgen VJ, Albrecht M, Kumar A, Tant M. New standards for driving and cardiovascular diseases: report of the Expert Group on Driving and Cardiovascular Disease. Brussels, October 2013. (22 September 2020).
    1. Clar C, Oseni Z, Flowers N, Keshtkar‐Jahromi M, Rees K. Influenza vaccines for preventing cardiovascular disease. Cochrane Database Syst Rev 2015;5:CD005050.
    1. Rodrigues BS, David C, Costa J, Ferreira JJ, Pinto FJ, Caldeira D. Influenza vaccination in patients with heart failure: a systematic review and meta‐analysis of observational studies. Heart 2020;106:350–357.
    1. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos GS, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride P, Peterson PN, Stevenson LW, Westlake C. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Card Fail 2017;23:628–651.
    1. Bhatnagar A, Payne TJ, Robertson RM. Is there a role for electronic cigarettes in tobacco cessation? J Am Heart Assoc 2019;8:e012742.
    1. Bhatnagar A, Maziak W, Eissenberg T, Ward KD, Thurston G, King BA, Sutfin EL, Cobb CO, Griffiths M, Goldstein LB, Rezk‐Hanna M. Water pipe (hookah) smoking and cardiovascular disease risk: a scientific statement from the American Heart Association. Circulation 2019;139:e917–e936.
    1. Ghuran A, Nolan J. Recreational drug misuse: issues for the cardiologist. Heart 2000;83:627–633.
    1. Reyes EB, Ha JW, Firdaus I, Ghazi AM, Phrommintikul A, Sim D, Vu QN, Siu CW, Yin WH, Cowie MR. Heart failure across Asia: same healthcare burden but differences in organization of care. Int J Cardiol 2016;223:163–167.
    1. Halladay JR, Vu M, Ripley‐Moffitt C, Gupta SK, O'Meara C, Goldstein AO. Patient perspectives on tobacco use treatment in primary care. Prev Chronic Dis 2015;12:E14.
    1. Pipe AL, Eisenberg MJ, Gupta A, Reid RD, Suskin NG, Stone JA. Smoking cessation and the cardiovascular specialist: Canadian Cardiovascular Society position paper. Can J Cardiol 2011;27:132–137.
    1. Jonkman NH, Westland H, Groenwold RH, Ågren S, Atienza F, Blue L, Bruggink‐André de la Porte PW, DeWalt D, Hebert PL, Heisler M, Jaarsma T, Kempen GI, Leventhal ME, Lok DJ, Mårtensson J, Muñiz J, Otsu H, Peters‐Klimm F, Rich MW, Riegel B, Strömberg A, Tsuyuki RT, van Veldhuisen D, Trappenburg JC, Schuurmans MJ, Hoes AW. Do self‐management interventions work in patients with heart failure? An individual patient data meta‐analysis. Circulation 2016;133:1189–1198.
    1. Jonkman NH, Westland H, Groenwold RH, Ågren S, Anguita M, Blue L, de la Bruggink‐André Porte PW, DeWalt DA, Hebert PL, Heisler M, Jaarsma T, Kempen GI, Leventhal ME, Lok DJ, Mårtensson J, Muñiz J, Otsu H, Peters‐Klimm F, Rich MW, Riegel B, Strömberg A, Tsuyuki RT, Trappenburg JC, Schuurmans MJ, Hoes AW. What are effective program characteristics of self‐management interventions in patients with heart failure? An individual patient data meta‐analysis. J Card Fail 2016;22:861–871.
    1. Oyanguren J, Latorre Garcia PM, Torcal Laguna J, Lekuona Goya I, Rubio Martín S, Maull Lafuente E, Grandes G. Effectiveness and factors determining the success of management programs for patients with heart failure: a systematic review and meta‐analysis. Rev Esp Cardiol 2016;69:900–914.
    1. Mentz RJ, Kelly JP, von Lueder TG, Voors AA, Lam CS, Cowie MR, Kjeldsen K, Jankowska EA, Atar D, Butler J, Fiuzat M, Zannad F, Pitt B, O'Connor CM. Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction. J Am Coll Cardiol 2014;64:2281–2293.
    1. Eurlings C, Boyne JJ, de Boer RA, Brunner‐La Rocca HP. Telemedicine in heart failure – more than nice to have? Neth Heart J 2019;27:5–15.
    1. Koehler F, Koehler K, Deckwart O, Prescher S, Wegscheider K, Kirwan BA, Winkler S, Vettorazzi E, Bruch L, Oeff M, Zugck C, Doerr G, Naegele H, Störk S, Butter C, Sechtem U, Angermann C, Gola G, Prondzinsky R, Edelmann F, Spethmann S, Schellong SM, Schulze PC, Bauersachs J, Wellge B, Schoebel C, Tajsic M, Dreger H, Anker SD, Stangl K. Efficacy of telemedical interventional management in patients with heart failure (TIM‐HF2): a randomised, controlled, parallel‐group, unmasked trial. Lancet 2018;392:1047–1057.
    1. Abraham WT, Stevenson LW, Bourge RC, Lindenfeld JA, Bauman JG, Adamson PB. Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow‐up results from the CHAMPION randomised trial. Lancet 2016;387:453–461.
    1. Hindricks G, Taborsky M, Glikson M, Heinrich U, Schumacher B, Katz A, Brachmann J, Lewalter T, Goette A, Block M, Kautzner J, Sack S, Husser D, Piorkowski C, Søgaard P. Implant‐based multiparameter telemonitoring of patients with heart failure (IN‐TIME): a randomised controlled trial. Lancet 2014;384:583–590.
    1. National Institute for Health and Care Excellence . Chronic heart failure in adults: diagnosis and management. NICE guideline [NG106]. 12 September 2018. (22 September 2020).
    1. Wirta SB, Balas B, Proenca CC, Bailey H, Phillips Z, Jackson J, Cotton S. Perceptions of heart failure symptoms, disease severity, treatment decision‐making, and side effects by patients and cardiologists: a multinational survey in a cardiology setting. Ther Clin Risk Manag 2018;14:2265–2272.
    1. De Smedt RH, Denig P, Haaijer‐Ruskamp FM, Jaarsma T. Perceived medication adverse effects and coping strategies reported by chronic heart failure patients. Int J Clin Pract 2009;63:233–242.
    1. Rogers A, Addington‐Hall JM, McCoy AS, Edmonds PM, Abery AJ, Coats AJ, Gibbs JS. A qualitative study of chronic heart failure patients' understanding of their symptoms and drug therapy. Eur J Heart Fail 2002;4:283–287.
    1. De Smedt RH, Denig P, van der Meer K, Haaijer‐Ruskamp FM, Jaarsma T. Self‐reported adverse drug events and the role of illness perception and medication beliefs in ambulatory heart failure patients: a cross‐sectional survey. Int J Nurs Stud 2011;48:1540–1550.
    1. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D. Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the Studies of Left Ventricular Dysfunction. Am Heart J 1994;128:358–364.
    1. Rosmalen JG, Neeleman J, Gans RO, de Jonge P. The association between neuroticism and self‐reported common somatic symptoms in a population cohort. J Psychosom Res 2007;62:305–311.
    1. Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, Fine LJ, Haley WE, Hawfield AT, Ix JH, Kitzman DW, Kostis JB, Krousel‐Wood MA, Launer LJ, Oparil S, Rodriguez CJ, Roumie CL, Shorr RI, Sink KM, Wadley VG, Whelton PK, Whittle J, Woolard NF, Wright JT Jr, Pajewski NM; SPRINT Research Group . Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years: a randomized clinical trial. JAMA 2016;315:2673–2682.
    1. Lancaster K, Abuzour A, Khaira M, Mathers A, Chan A, Bui V, Lok A, Thabane L, Dolovich L. The use and effects of electronic health tools for patient self‐monitoring and reporting of outcomes following medication use: systematic review. J Med Internet Res 2018;20:e294.
    1. Mullens W, Damman K, Testani JM, Martens P, Mueller C, Lassus J, Tang WH, Skouri H, Verbrugge FH, Orso F, Hill L, Ural D, Lainscak M, Rossignol P, Metra M, Mebazaa A, Seferovic P, Ruschitzka F, Coats A. Evaluation of kidney function throughout the heart failure trajectory – a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2020;22:584–603.
    1. Piano MR, Prasun MA, Stamos T, Groo V. Flexible diuretic titration in chronic heart failure: where is the evidence? J Card Fail 2011;17:944–954.
    1. Martens P, Verbrugge FH, Boonen L, Nijst P, Dupont M, Mullens W. Value of routine investigations to predict loop diuretic down‐titration success in stable heart failure. Int J Cardiol 2018;250:171–175.
    1. Sica DA, Muntendam P, Myers RL, ter Maaten JM, Sale ME, de Boer RA, Pitt B. Subcutaneous furosemide in heart failure: pharmacokinetic characteristics of a newly buffered solution. JACC Basic Transl Sci 2018;3:25–34.
    1. Simonavicius J, Sanders van‐Wijk S, Rickenbacher P, Maeder MT, Pfister O, Kaufmann BA, Pfisterer M, Čelutkienė J, Puronaitė R, Knackstedt C, van Empel V, Brunner‐La Rocca HP. Prognostic significance of longitudinal clinical congestion pattern in chronic heart failure: insights from TIME‐CHF trial. Am J Med 2019;132:e679–692.
    1. Wagenaar KP, Broekhuizen BD, Jaarsma T, Kok I, Mosterd A, Willems FF, Linssen GC, Agema WR, Anneveldt S, Lucas CM, Mannaerts HF, Wajon EM, Dickstein K, Cramer MJ, Landman MA, Hoes AW, Rutten FH. Effectiveness of the European Society of Cardiology/Heart Failure Association website ‘’ and an e‐health adjusted care pathway in patients with stable heart failure: results of the ‘e‐Vita HF’ randomized controlled trial. Eur J Heart Fail 2019;21:238–246.
    1. Jaarsma T, Arestedt KF, Martensson J, Dracup K, Stromberg A. The European Heart Failure Self‐care Behaviour scale revised into a nine‐item scale (EHFScB‐9): a reliable and valid international instrument. Eur J Heart Fail 2009;11:99–105.
    1. Sedlar N, Lainscak M, Mårtensson J, Strömberg A, Jaarsma T, Farkas J. Factors related to self‐care behaviours in heart failure: a systematic review of European Heart Failure Self‐care Behaviour scale studies. Eur J Cardiovasc Nurs 2017;16:272–282.
    1. Riegel B, Barbaranelli C, Carlson B, Sethares KA, Daus M, Moser DK, Miller J, Osokpo OH, Lee S, Brown S, Vellone E. Psychometric testing ofs the revised Self‐Care of Heart Failure Index. J Cardiovasc Nurs 2019;34:183–192.
    1. Jaarsma T, Cameron J, Riegel B, Stromberg A. Factors related to self‐care in heart failure patients according to the middle‐range theory of self‐care of chronic illness: a literature update. Curr Heart Fail Rep 2017;14:71–77.

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