A woman and man are sitting by a lake holding each other and looking at the water

Navigating heart failure and lymphoedema coexistence

Compression therapy for patients with heart failure

Many healthcare professionals have avoided applying compression therapy to patients with heart failure and oedema for fear of overloading the heart. Compression therapy is the gold standard of care for treating lower limb oedema and leg ulceration. Knowledge gaps and misconceptions have led to many myths amongst healthcare professionals, often preventing this patient group receiving the necessary treatment to manage their oedema effectively. New guidance is now available.

Heart failure affects an estimated 920,000 people in the UK1. The number of people affected is likely to increase due to an ageing population, improved cardiac survival rates due to advances in emergency medicine2, and an increase in the number of patients at risk due to diabetes, high blood pressure, and social deprivation3.

What do healthcare professionals need to know about lymphoedema and heart failure?

Managing patients with coexisting heart failure and lymphoedema can present challenges for healthcare professionals, particularly when considering compression therapy. A UK-wide survey explored healthcare professionals’ knowledge, confidence and educational needs when caring for this patient group. The research identified uncertainty around compression therapy, gaps in collaboration and a need for further education and clearer clinical pathways.

Watch the video as Dr Garry Cooper discusses the findings from the study4,5 and what they mean for clinical practice, including common myths around compression therapy and heart failure, key guidance and resources, and his recommendations for fellow clinicians.

Best Practice Statement

Put the evidence into practice with guidance to support clinical decision-making

The Best Practice Statement: The Use of Compression Therapy for Peripheral Oedema: Considerations in People with Heart Failure, published by Wounds UK6, addresses common misconceptions around compression therapy and provides practical guidance for managing patients with heart failure and peripheral oedema.

“It is vital to remember apathy is not harm free, watching legs increase in size, blister and weep can be harmful to patients with this condition.”

Leanne Atkin, Vascular Nurse Consultant, Mid Yorkshire NHS Trust; Research Fellow, University of Huddersfield; Member of Legs Matter.

Access free heart failure and lymphoedema education

Can I safely apply compression?

A question healthcare professionals often ask when caring for a patient with heart failure and lower limb oedema. Build your knowledge and confidence with the 'Management of patients with heart failure and lower limb swelling' webcast on our PATH platform. Explore the challenges of managing heart failure and lymphoedema when they coexist, misconceptions around compression therapy, and considerations for clinical practice.

Further reading

The full studies4,5 are available to explore the research in more detail.

Lymphoedema and heart failure staff educational needs analysis: insights from a UK online survey. Part 1: qualitative findings. Read part 1.

Lymphoedema and heart failure staff educational needs analysis: insights from a UK online survey. Part 2: quantitative findings. Read part 2.

Frequently asked questions

Compression therapy can be used in patients with heart failure and lymphoedema, following appropriate assessment. Healthcare professionals should follow current clinical guidance to determine the appropriate approach to compression therapy for each patient.  

Access the ‘Management of patients with heart failure and lower limb swelling’ webcast on PATH to build your knowledge and confidence. The webcast explores heart failure and lymphoedema coexistence, misconceptions around compression therapy, and considerations for clinical practice. Watch webcast.

Download the Best Practice Statement: The Use of Compression Therapy for Peripheral Oedema: Considerations in People with Heart Failure for practical guidance on using compression therapy in patients with heart failure. The statement addresses common misconceptions and provides guidance to support clinical decision-making. Download Best Practice Statement.

References

1. Conrad N, Judge A, Tran J et al (2018) Temporal trends and patterns in heart failure incidence: a population based study of 4 million individuals. The Lancet 391: 10120
2. Hobbs FD, Kenkre JE, Roalfe AK et al (2002) Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population. European Heart Journal 23: 1867–76
3. Danielsen R, Thorgeirsson G, Einarsson H et al (2017) Prevalence of heart failure in the elderly and future projections: the AGES-Reykjavík study. Scandinavian Cardiovascular Journal 51: 183–9
4. Lymphoedema and heart failure staff educational needs analysis: insights from a UK online survey. Part 1: qualitative findings. British Journal of Community Nursing Chronic Oedema Supplement, S23, October 2025 
5. Lymphoedema and heart failure staff educational needs analysis: insights from a UK online survey. Part 2: quantitative findings. British Journal of Community Nursing Chronic Oedema Supplement, S32, October 2025.
6. Wounds UK (2023) Best Practice Statement: The use of compression therapy for peripheral oedema: considerations in people with heart failure. Wounds UK, London. Available to download from: www.wounds-uk.com