Many factors can affect a person’s life expectancy with congestive heart failure (CHF), such as their age, the stage of their condition, and the strength of their heart function.

CHF is a chronic, progressive condition that affects the heart’s ability to pump blood around the body.

Despite its name, CHF does not mean the heart has completely failed. However, CHF can be life threatening if left untreated.

In general, more than half of all people with CHF survive for 5 years after diagnosis, according to a 2019 systematic review and meta‐analysis. About 35% survive for 10 years.

Many conditions that weaken the heart can contribute to the development of CHF, including:

However, in some cases, a person can extend their life expectancy through lifestyle changes, medications, and surgery.

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Life expectancy with CHF depends on several variables and may be nonlinear. A 2018 review highlights that many physicians feel they cannot confidently predict a person’s clinical trajectory in a 6-month time frame.

A 2019 meta‐analysis estimates the following survival rates for all-type heart failure:

  • 1 year: 87%
  • 2 years: 73%
  • 5 years: 57%
  • 10 years: 35%

However, life expectancy for a person with CHF has substantially improved over time.

A person’s age at diagnosis may affect their outlook. The 2019 meta-analysis reports that the 5-year survival rate for people under age 65 years was around 79%, while the rate was about 50% for those age 75 years and over.

Additionally, how much blood a person’s heart pumps out per beat, known as the ejection fraction (EF), may affect life expectancy.

Doctors note a person’s EF as a percentage. A normal output is 55–70%. People with an EF under 40% may have a higher risk of dying from CHF.

However, a 2017 study reports that the 5-year life expectancy is poor among all people admitted to the hospital with heart failure regardless of their EF. Researchers estimate the 5-year death rate is 75.4%.

The 2019 meta-analysis mentioned earlier also found no significant difference in survival rates between people with an EF below 40% and those with an EF above 40%.

The presence of underlying conditions or comorbidities, such as coronary heart disease, can affect a person’s life expectancy as well.

An age-adjusted study from 2021 found that comorbidities are common in people with heart failure and can contribute to higher death rates. For example, the study found diabetes is present in 28% of deaths. Chronic obstructive pulmonary disease (COPD) is present in 16% of deaths.

Risk factors, such as obesity, high blood pressure, and eating patterns, may also negatively affect a person’s outlook.

CHF does not have a current cure, but early detection and treatment may help improve a person’s life expectancy. Following a treatment plan that includes lifestyle changes may help improve their quality of life.

In CHF, the heart muscles may become too stiff or weak to pump blood efficiently. This means that instead of the heart pushing blood out, blood collects in the heart. The blood that remains in the heart can cause fluid retention.

Common symptoms of heart disease include:

Other conditions that affect the heart can also cause CHF. An early diagnosis of CHF may help people manage their symptoms and make preventive lifestyle changes.

Doctors often assess a person’s functional heart capacity using the New York Heart Association’s classification system. The classes are:

  • Class 1: A person has no limitation on their physical activity and no adverse symptoms.
  • Class 2: There is a slight limitation on physical activity, but the person is comfortable at rest.
  • Class 3: A person has a notable limitation on their physical activity, but they remain comfortable at rest.
  • Class 4: A person cannot engage in physical activity without discomfort. They have symptoms of heart failure at rest.

A second classification system, defined by the American College of Cardiology and the American Heart Association, details four stages of heart disease.

Learn more about these four stages here.

Medical treatment for CHF may involve medications to reduce the amount of fluid in the body. Reducing excess fluid may ease some of the strain on the heart and improve its ability to pump blood.

Doctors may prescribe diuretics to help the body eliminate excess liquid. Common diuretics include:

Doctors may also prescribe medications to help the heart pump blood more effectively, such as:

However, a 2018 review notes the effects these treatments may have on mortality are unclear.

Other key components of CHF treatment include:

  • Mineralocorticoid receptor blockers (MRAs): Doctors recommend MRAs for people with an EF of 35% or less. MRAs can help improve blood flow and heart function.
  • Sodium-glucose co-transporter-2 (SGLT2) inhibitors: SGLT2 inhibitors can assist in glucose control and reduce the risk of heart complications.

Doctors may also prescribe beta-blockers to support these efforts and control the heart rate.

Some people may also require physical interventions to treat CHF.

For instance, implantable cardiac defibrillators (ICDs) can protect against sudden cardiac arrest. Cardiac resynchronization therapy (CRT) can regulate heart rhythm. Both procedures involve a healthcare professional attaching small electrical devices to a person’s heart.

In the later stages of heart failure, doctors may recommend surgery to insert a left ventricular assisted device (LVAD) into a person’s heart. An LVAD is a pump that helps the heart muscle contract. It can be a permanent solution for people with heart failure.

A heart transplant may also be an option if the person is a good candidate for the surgery.

Doctors will likely recommend a person make lifestyle changes to minimize the effects of CHF. Lifestyle changes are recommended regardless of a person’s CHF stage or other treatments they are following.

According to a 2018 study, lifestyle changes may help slow the progression of heart failure conditions and increase a person’s quality of life. They include:

Diet and exercise

Eating a balanced, nutritious diet and getting regular exercise are healthy strategies for all people, but they can be essential for people with CHF.

Doctors may recommend that people with CHF eliminate excess salt or sodium from their diet. Too much sodium causes the body to retain fluids. Doctors may also suggest reducing or limiting alcohol and overall fluid intake.

Regular aerobic exercise may improve heart health and lead to a better quality of life in people with CHF. Physical conditioning can improve a person’s quality of life and exercise tolerance. It can reduce hospitalization rates in people with heart failure.

Aerobic exercise is any activity that elevates the heart and breathing rates. Such activities include swimming, cycling, or jogging.

However, increasing physical activity may not be practical for everyone with CHF. A person can talk with their doctor before starting any exercise regimen.

Fluid restriction

People with CHF tend to retain fluid in their bodies. To mitigate this, doctors sometimes recommend limiting a person’s daily fluid intake within safe boundaries.

Consuming too much liquid may cancel out the effects of diuretic medications. While it is essential to stay hydrated, a doctor can recommend just how much fluid a person can safely consume in a day.

Weight management

Obesity is a known risk factor for heart failure. Research shows that weight loss and subsequent management can be effective in the prevention of heart failure.

However, a doctor may not always advise weight loss for people with CHF. In some circumstances, rapid weight loss may be an early sign of other conditions, such as cachexia.

Doctors often ask people to monitor their weight daily to check for any sudden or fast weight gains, which may be a sign of fluid retention.

In addition, monitoring a person’s weight every day can help a doctor prescribe the correct levels of diuretics to help the body release fluid.

Below are some frequently asked questions about CHF and life expectancy.

How long can a person live with congestive heart failure?

Research estimates that more than half of all people with congestive heart failure will survive for 5 years after diagnosis. About 35% will survive for 10 years.

However, in some cases, a person can extend their life expectancy through lifestyle changes, medications, and surgery.

Can a person recover from congestive heart failure?

There is no cure for CHF. However, certain lifestyle changes, such as restricting sodium intake and regular aerobic exercise, may help slow the condition’s progression and increase a person’s quality of life.

When is it time for hospice with congestive heart failure?

It may be time for hospice care for a person with CHF when they begin to experience persistent, severe symptoms that interfere with their everyday life.

Hospice care might also be considered if a person has recurrent or complicated hospitalizations, such as an ICU stay.

Each person with CHF will have a different experience. Life expectancy for the disease varies significantly between individuals. Some studies estimate a 5-year survival rate of nearly 50% for a person with heart failure.

Life expectancy depends on a person’s stage and class of CHF and what other complications or health problems they have. People who have received an early diagnosis may have a better outlook than those who did not.

Many people find that positive lifestyle changes can significantly improve their CHF symptoms and well-being. In addition, medications help many people with CHF. Doctors sometimes recommend surgery.

A person with CHF can work directly with their doctor and medical team to make an individualized treatment plan to have the best possible outlook.