Congestive heart failure (CHF) typically occurs due to another condition that damages the heart. However, family history of CHF and some genetic mutations may increase someone’s risk of developing the condition.

According to the National Heart, Lung, and Blood Institute (NHLBI), CHF is a progressive condition in which the heart is unable to pump enough blood to supply oxygen to the body’s organs. As the heart cannot pump efficiently, a buildup of fluid occurs.

Blood returning to the heart builds up in bodily tissues, causing swelling, usually in the legs and ankles.

In this article, we explain what CHF is and how genetics play a part. We also look at other causes and how individuals can reduce their risk of the condition.

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CHF is a progressive condition in which the heart slowly loses its ability to pump enough blood to supply the organs with oxygen.

According to the Centers for Disease Control and Prevention (CDC), the condition affects approximately 6.2 million adults in the United States.

Although CHF can develop at any age, it usually occurs in people over the age of 65 years. The condition starts slowly and gradually worsens as more fluid builds up in the tissues. Medical experts refer to this buildup of fluid as congestion.

Over time, the fluid accumulates in the legs, ankles, and feet, causing swelling. The swelling can occur in other parts of the body as well, including the lungs. This can lead to shortness of breath, and even difficulty breathing when lying down.

The CDC states that while people can manage CHF with medications and lifestyle changes, the only cure is a heart transplant.

Two different forms of CHF are systolic CHF and diastolic CHF. Systolic CHF develops when the left ventricle is unable to contract strongly enough during a heartbeat, meaning that the heart is unable to pump enough oxygen around the body.

Diastolic CHF occurs when the left ventricle does not fully relax between heartbeats, meaning that it does not completely fill up with enough blood to pump around the body.

Many of the risk factors for systolic CHF — such as high blood pressure, or hypertension — can run in families.

Diastolic CHF typically occurs due to untreated heart conditions, such as arrhythmia. Some of these conditions can also have a hereditary component.

Learn more about the differences between diastolic and systolic heart failure here.

CHF usually stems from another condition that damages the heart. A person may inherit some of these conditions, including high blood pressure and certain types of cardiomyopathy.

The American Heart Association (AHA) explains that congenital heart defects are not the same as heart disease. Congenital heart defects are abnormalities in the heart that are present at birth. Some of these are related to genes.

Also, the AHA estimates that the likelihood of a heart defect recurring in the family is between 2 and 15%. However, having a congenital heart defect may increase the risk of developing CHF.

According to the AHA, discovering the hereditary roots of some heart conditions can help doctors and patients identify risks and decide on most suitable treatments.

However, while significant advances in research are improving the understanding of the role of genetics in CHF, more research in this field is necessary.

The authors of research from 2018 observe that cardiomyopathies are one of the most common causes of CHF. They note that almost 100 gene mutations can cause cardiomyopathies. However, the majority of these mutations are associated with dilated cardiomyopathy or hypertrophic cardiomyopathy.

Dilated cardiomyopathy affects the pumping chambers, or ventricles, of the heart. The heart is also much larger than normal.

Hypertrophic cardiomyopathy is where the heart muscles thicken. Doctors often diagnose this condition in children and adolescents.

In addition, while genetic mutations can cause heart failure, not everyone with the gene will develop the condition. Environmental factors also play a role. However, identifying people at high risk of CHF, even before they experience any symptoms, may improve their overall outlook.

The CDC notes that while high blood pressure may have a genetic component, the risk increases when combined with certain lifestyle choices. Eating an unhealthy diet, drinking alcohol, and smoking may increase the risk of a person with high blood pressure of developing CHF.

Other cardiovascular conditions that may be hereditary are:

Not all risk factors for CHF are hereditary. According to the NHLBI, other risk factors include:

  • Age: The likelihood of developing CHF increases with age.
  • Race or ethnicity: African Americans are most likely to have CHF. Additionally, they may develop CHF at a younger age and may have a more severe condition than other populations.
  • Sex: Although CHF is common in both males and females, females often experience worse symptoms than males.
  • Underlying medical conditions: Some long-term health conditions increase a person’s likelihood of CHF. These include:
  • Injuries to the heart: Previous heart attacks and some chemotherapy and radiation treatments can damage the heart muscle, raising the CHF risk.
  • Lifestyle habits: A lack of physical activity, smoking, excessive alcohol consumption, and unhealthy diets contribute to a higher risk of CHF.

While it is not possible to avoid all the risk factors for CHF, making some lifestyle changes can help a person improve their heart health.

The NHLBI recommends the following:

The NHLBI also notes that some emotions, particularly anger, may trigger a heart attack and that long-term stress is a recognized risk factor in heart disease. It is therefore advisable to find healthy ways to manage stress and cope with emotions.

Eating a heart-healthy diet is also important. This involves:

  • eating more vegetables, fruit, and whole grains
  • consuming more lean proteins and unsaturated fats
  • avoiding foods high in salt, such as processed meats, and choosing low sodium or reduced salt options
  • cutting down on added sugars

Additionally, getting regular exercise can improve overall fitness. People should discuss any plans to start a new exercise regime with a doctor before starting.

However, the Department of Health and Human Services recommends a combination of moderate- and high-intensity exercise weekly. This can be 30 minutes of moderate activity 5 days per week and 25 minutes of high-intensity exercise 3 times per week.

CHF is a progressive condition where the heart slowly loses its ability to pump blood. While genetics may affect an individual’s likelihood of developing the condition, CHF does not always occur in people with genetic mutations.

There is no cure for CHF, but a person can manage the condition with medication and lifestyle changes.