One of the commonest presentations is breathlessness on exertion, which is often confused as a part of aging or being obese. Not being able to climb stairs may be the earliest sign of hypertensive diastolic heart failure. Other signals are:

• Feeling extra tired even after a good night’s sleep. People with heart failure may limit activities they like to do or take naps to avoid feeling tired.
• Weight gain: Call your doctor if you gain weight for more than 2 days in a row or if you gain 2 or more pounds.
• Shortness of breath: Heart failure makes breathing harder, especially during exercise. Lying position may make it worse.
• Swollen ankles, legs, belly, and/or lower back, the swelling is often worse at the end of the day.
• Going to the bathroom more at night.