CHF is no different from any other heart problem in that it seems to be caused mainly by diet and lifestyle. So, to prevent it:

* Eat a Mediterranean diet, including lots of beans, peas, fish, fruit, vegetables, cereals and olive oil, and not so much meat, fat and eggs (Circulation, 1999; 99: 779-85). A high dairy intake can increase heart disease risk (Altern Med Rev, 1998; 4: 281-94)

* Avoid the standard heart-healthy low-fat, low-cholesterol diet. In one Indian study, those on a Mediterranean diet had half the heart symptoms and nearly one-third the deaths from heart attack as those on a low-fat diet (Lancet, 2002; 360: 1455-61)

* Avoid high-glycaemic, processed foods, linked to high cholesterol and other heart problems

* Stop smoking

* Eat nuts; they dramatically reduce the risk of heart disease (BMJ, 1998; 317: 1341-5)

* Avoid hydrogenated fats and trans fatty acids, found in most processed foods, particularly margarine (Lancet, 1993; 341: 581-5)

* Consume foods rich in flavonoid antioxidants - brightly coloured fresh fruits and vegetables, grape juice, green tea, red wine in moderation (J Nutr, 2000; 130: 53-6). Flavonoids contain proanthocyanidins and tannins, which strengthen blood vessels and blood flow

* Two-and-a-half servings of wholegrains a day can cut your heart disease risk by a third (Am J Clin Nutr, 1999; 70: 412-9)

* Exercise regularly - even just walking increases the levels of protective HDL (JAMA, 1991; 266: 3295-9). In those with CHF, regular exercise reduced mortality by 40 per cent, and 60 minutes of cycling three times a week significantly lowered death rates, and improved heart function and quality of life (BMJ, 2004; 328; 189; Circulation, 1999; 99: 1173-82)

* Supplement with coenzyme Q10 (10-30 mg/day for general prevention; 200-400 mg/day as therapy). In nearly 3000 people with CHF, 50-150 mg/day for three months reduced fluid retention by 80 per cent, heart palpitations by 75 per cent, and liver enlargement and shortness of breath by 50 per cent (Mol Aspects Med, 1997; 18: S159-68). Also, just 60 mg of CoQ10 twice a day reduced high systolic blood pressure by a massive 18 mmHg (South Med J, 2001; 94: 1112-7). Moreover, CoQ10 appears to help us live longer. Says Dr Lansjoen, 'People who make it to the age of 90 tend to have high Q10 levels.'

In addition, supplement with:

* Vitamin E (400 IU/day) to neutralise ‘bad’ LDL cholesterol (Arterioscler Thromb, 1993; 13: 1779-89)

* Vitamin C (at least 1 g/day) to maintain healthy blood vessels (Am J Clin Nutr, 1974; 27: 866-76)

* A multivitamin rich in the other antioxidants (such as vitamin A and selenium, which may help with any statin-induced damage) plus an evening supplement of zinc

* L-Carnitine, a non-essential amino acid (1-4 g/day), which increases ‘good’ HDL cholesterol (Curr Ther Res, 1980; 27: 208-16) and helps improve tolerance to exercise (Jpn Heart J, 1984; 25: 587-97; Clin Terap [Ital], 1992; 140: 353-77)

* Magnesium, the heart mineral, which may reduce cardiovascular spasm (Magnesium, 1985; 4: 226-44)

* Chondroitin (1500 mg/day), which can 'dramatically' reduce the risk of heart attack (Angiology, 1973; 24: 269-87)

* Brewer’s yeast (2 tsp/day) contains chromium and lowers cholesterol (Nutr Res, 1989; 9: 989-98)

* Psyllium (5-10 g/day) lowers LDL by almost 10 per cent (J Nutr, 1997; 127: 1973-80)

* Fenugreek seed powder (25-50 g/day) can increase HDL (Phytother Res, 1991; 5: 145-7)

* Beware of environmental toxins, which have been linked to heart disease and heart inflammation (N Engl J Med, 1997; 337: 422-4).