Knowing More About Heart Failure: All About HFpEF And HFrEF

Knowing More About Heart Failure: All About HFpEF And HFrEF

While HFpEF and HFrEF are severe, they can be managed with timely diagnosis and proper medication.

Written by Tavishi Dogra |Updated : May 11, 2023 11:37 AM IST

Heart failure is a common medical condition globally and in India. In India, about 1% to 1.5% of the adult population is estimated to have heart failure, with higher mortality rates than global standards. Heart failure is a progressive and potentially fatal condition when the heart cannot supply adequate circulation to meet the body's demands for oxygenated blood. This often leads to fluid accumulation (congestion) in the lungs and peripheral tissues and limits blood supply to various vital organs. As a result, heart failure adversely impacts a patient's life quality, and even conducting daily tasks becomes challenging.

Patients are often tired easily and experience frequent shortness of breath. They also experience slower recovery from tiredness and swelling in the feet. The condition can lead to frequent hospitalization and even mortality if left unchecked. Thus, to better understand the state and its potential impact, patients need to know about the various types of heart failure and their characteristics. Heart failure is increasingly classified based on the heart's pumping ability, which can be determined by measuring left ventricular ejection fraction (LVEF) using echocardiography.

These Are:

  1. HFrEF, also known as systolic heart failure, where the LVEF is typically 40%
  2. Heart Failure with mildly reduced Ejection Fraction (HFmrEF), where the LVEF generally is between 41-49%
  3. HFpEF also known as diastolic heart failure, where the LVEF is typical 50%

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HFrEF occurs when the heart's left ventricle fails to pump blood properly. As the heart muscle cannot contract adequately, less oxygen-rich blood flows into the body. HFrEF is more common in males than females.


HFpEF occurs when the heart's left ventricle is not filled correctly, leading to an eventual accumulation of blood in the lungs. HFpEF is frequently associated with comorbidities like hypertension (high blood pressure), type-2 diabetes, ischemic heart disease and atrial fibrillation. Women are disproportionately affected by HFpEF, outnumbering men 2:1. According to estimates, HFpEF accounts for about 1/3rd of all heart failure cases diagnosed in India.

While the mortality rates for HFrEF and HFpEF are similar, HFpEF seems less familiar in occurrence than HFrEF, possibly due to underdiagnosis.

Dealing With Heart Failure

Heart failure can be complex, but sustained efforts can help immensely.

  1. Maintaining a healthy and balanced diet: Eating a healthy, balanced diet rich in vegetables, legumes, and fruit can be helpful to patients. Also, they must avoid fatty food products and reduce their salt intake.
  2. Moderate intensity exercise regularly: Moderate physical activity can help deal with heart disease and build physical and psychological resilience. However, patients must not overdo it and only proceed after speaking to their doctor.
  3. Restricting alcohol and tobacco consumption: Alcohol and tobacco consumption can harm the heart. Patients must ensure that they cut down on both.
  4. Avoiding stress to the extent possible: Patients should avoid stress and straining themselves. Instead, they should adopt an optimistic attitude towards life.

Taking prescribed medication properly and monitoring their health constantly.


Heart failure patients must abide by their doctor's orders and adhere to their medication religiously. Also, they must monitor their health constantly. HFrEF patients, in particular, might also use devices such as an implantable cardioverter defibrillator, which helps regulate the heart rhythm. While HFpEF and HFrEF are severe, they can be managed with timely diagnosis and proper medication. Proper management can radically improve the quality of life in patients and help them live longer lives with a lesser burden of hospitalization.