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.

中文翻译：

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超越指南指导的药物治疗：心力衰竭患者的非药物治疗。


心力衰竭 （HF） 是导致心血管疾病发病率、死亡率和医疗保健支出的主要原因。HF 患者以指南为导向的药物治疗和基于设备的治疗已得到广泛确立。然而，非药物方式在改善 HF 护理方面的作用仍然没有得到充分认识，未得到充分利用，需要多模式的护理方法。饮食、运动和心脏康复、睡眠呼吸障碍、情绪障碍和物质使用障碍是降低 HF 患者发病率和改善功能的潜在目标。解决这些因素可能会改善症状和生活质量，减少住院治疗，并改善心力衰竭的死亡率。本最新综述讨论了心力衰竭患者的饮食干预、锻炼计划以及睡眠呼吸障碍、情绪障碍和物质使用的管理。作者回顾了最新数据，并提供了最佳生活方式建议和非药物治疗的推荐处方。