Which lifestyle modification has strong evidence for improving outcomes in CHF?

• A. Regular aerobic exercise and sodium restriction
• B. Complete bed rest
• C. High-sodium diet
• D. Smoking cessation only

Answer: (A)

Regular aerobic exercise with sodium restriction provides the strongest evidence for improving outcomes in chronic heart failure. Aerobic training improves functional capacity, symptoms, and quality of life, and it can reduce hospitalizations by enhancing muscle efficiency, endothelial function, and autonomic balance. Sodium restriction helps control fluid overload and edema, making symptoms easier to manage and often improving response to diuretics. Together, they tackle both conditioning and fluid status, which are key to better outcomes in heart failure. While complete bed rest is harmful and leads to deconditioning, a high-sodium diet worsens congestion, and smoking cessation, though beneficial, doesn’t address heart-failure-specific outcomes as robustly as combining exercise with sodium management.