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Long-term conditions

Heart failure – daily weights, salt and your medicines

What heart failure means, why weighing yourself every morning catches trouble early, which symptoms mean go to hospital, and how the medicines fit together.

What heart failure actually means

Heart failure does not mean the heart has stopped or is about to. It means the heart is not pumping as effectively as it should, so fluid backs up and the body does not get the blood flow it needs. The usual symptoms are breathlessness — especially on exertion or when lying flat — swollen ankles and legs, and tiredness.

In South Africa it follows uncontrolled high blood pressure more often than anything else, and also results from heart-muscle disease, damage after a heart attack, rheumatic heart disease and other causes. It is a long-term condition that is managed, and good management makes a large difference to how people feel and how often they end up in hospital.

Weigh yourself every morning

  • Tell your clinic about a rapid gain over one to three days, or a steady climb across a week.
  • Some clinicians give a personal plan for adjusting the water tablet when the weight rises. Follow the plan you were given; do not invent one.
  • Also watch for tighter shoes, rings, or a waistband, and for needing more pillows at night.

Salt, fluid and alcohol

  • Salt makes the body hold water, which is exactly what you are trying to avoid. Cut added salt, stock cubes, soup powders, processed meats and salty snacks.
  • Some people are given a daily fluid limit. If you have one, count everything liquid — tea, soup, cooldrink, porridge.
  • Alcohol weakens heart muscle and adds fluid. If a clinician has told you to stop, that advice is doing real work.
  • Weigh the tablet timing against your day: a water tablet taken late means a night of getting up.

The medicines and why there are several

Heart-failure treatment is usually several medicines together, each doing a different job, and the combination is what improves survival rather than any single one. Doses are often built up slowly over months, so a low starting dose is not a sign of a mild problem.

Medicines used in heart failure in South Africa:

  • Furosemide — Lasix, Puresis, Adco-Furosemide, Urex

    Oedema in heart failure, renal disease, liver cirrhosis; acute pulmonary oedema

  • Enalapril — Pharmapress, Enap, Adco-Enalapril, Renitec

    Hypertension; heart failure; diabetic nephropathy

  • Carvedilol — Carloc, Dilatrend, Coreg, Carvil

    Heart failure; hypertension; post-MI with LV dysfunction

  • Spironolactone — Aldactone, Spiractin, Aldazide (with HCT), Spironolactone Accord

    Heart failure; resistant hypertension; primary hyperaldosteronism; ascites

  • Dapagliflozin — Forxiga

    Type 2 diabetes; heart failure (with or without diabetes); chronic kidney disease

  • Digoxin — Lanoxin

    Atrial fibrillation (rate control); heart failure with reduced ejection fraction

When to get help

  • Contact the clinic sooner rather than later for a rapid weight gain, increasing ankle swelling, needing more pillows, or new tiredness that is not lifting.

Common questions

Why do I have to weigh myself every day with heart failure?
Because a sudden rise over a day or two is retained fluid, and it shows on the scale before you feel breathless. Catching it early usually means a medicine adjustment instead of a hospital admission.
Can I take ibuprofen if I have heart failure?
Generally no. Anti-inflammatory painkillers make the body retain fluid and raise blood pressure, which can worsen heart failure. Tell a pharmacist you have heart failure and ask for a safer option.
Does heart failure mean my heart is about to stop?
No. It means the heart is not pumping as efficiently as it should. It is a long-term condition that is managed with medicines, salt and fluid care, and daily weights.

Sources

Last reviewed 11 August 2026.

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