Heart failure occurs when the heart does not pump the blood strongly enough throughout the body. Symptoms include difficulty breathing, decreased ability to exercise, and leg swelling. It is common in older adults and black people. People with heart failure often require treatment in the hospital. Reasons for hospitalization include eating too much salt and taking drugs in doses that are too low and are ineffective, which may lead to worsening heart function. Also, people with heart failure often do not realize when their symptoms worsen and when they should seek medical attention. Older people, people with more severe heart failure, and those who cannot easily see a health care provider are at higher risk for hospitalization. Treatment programs in which nurses help people manage their condition might prevent hospitalization for high-risk patients. The effect of such programs has been tested in few people in minority populations.