Ramadan fasting effects on chronic heart failure symptoms

Introduction Over one billion Muslims elect to fast during the month of Ramadan worldwide. The data available regarding the effect of Islamic fasting in patients with heart failure and reduced ejection fraction (HFrEF) are insufficient. Methodology We prospectively studied 249 outpatients with HFrEF who plan to fast Ramadan in three Cardiac centers in Saudi Arabia. A detailed clinical assessment, diagnostic data, emergency department visit, and hospitalization during Ramadan and the preceding month were obtained. Results A total of 249 patients were enrolled, 227 (91%) patients fast for the full lunar month. During Ramadan 209 (92%) patients remained stable while 18 (8%) patients became unstable. With fasting, the mean New York Heart Association (NYHA) functional class was significantly lower in the stable when compared to the unstable group (1.46 ± 0.7 vs. 3.22 ± 0.55. P  Conclusion Ramadan fasting considered to be safe in the majority of patients with chronic HFrEF. Furthermore, non-adherence to medication and diet is the most important factor leading to heart failure decompensation during Ramadan.