Restricting sodium may be detrimental in chronic heart failure

Chronic heart failure patients who restrict sodium intake may increase the risk for poor outcomes.
Chronic heart failure patients who restrict sodium intake may increase the risk for poor outcomes.

HealthDay News — Sodium restriction may be harmful in patients with chronic heart failure, according to a study published in the Jan. 1 issue of JACC: Heart Failure.

Rami Doukky, MD, from the Rush University Medical Center in Chicago, and colleagues examined the impact of sodium restriction on heart failure outcomes using data from the multihospital Heart Failure Adherence and Retention Trial. Nine hundred two New York Heart Association functional class II/III heart failure patients were enrolled and followed for a median of 36 months. Patients were classified into sodium restricted (<2,500 mg/d) and unrestricted (≥2,500 mg/d) groups based on the mean sodium intake prior to the first event of death or heart failure hospitalization.

Sodium intake data were available for 833 patients (145 sodium restricted and 688 sodium unrestricted); 260 patients were propensity matched into sodium restricted and unrestricted groups. The researchers found that the risk of death or heart failure hospitalization was significantly higher with sodium restriction (hazard ratio, 1.85; 95% confidence interval, 1.21 to 2.84); this resulted from an increase in the rate of heart failure hospitalization (hazard ratio, 1.82; 95% confidence interval, 1.11 to 2.96) and a nonsignificant increase in the rate of cardiac death (hazard ratio, 1.62; 95% confidence interval, 0.70 to 3.73) and all-cause mortality (P = 0.074).

"In symptomatic patients with chronic heart failure, sodium restriction may have a detrimental impact on outcome," the authors write.

One author disclosed financial ties to Astellas Pharma.

References

  1. Doukky R, Avery E, Mangla A, et al. Impact of Dietary Sodium Restriction on Heart Failure Outcomes CME. JCHF. 2016;4(1):24-35. doi:10.1016/j.jchf.2015.08.007.
  2. Hummel SL, Konerman MC. Dietary Sodium Restriction in Heart Failure: A Recommendation Worth its Salt? JCHF. 2016;4(1):36-38. doi:10.1016/j.jchf.2015.10.003.
  3. Yancy CW. The Uncertainty of Sodium Restriction in Heart Failure: We Can Do Better Than This. JCHF. 2016;4(1):39-41. doi:10.1016/j.jchf.2015.11.005.
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