Sodium Restriction in Heart Failure: Benefit or Harm?

Overview

Journal Curr Treat Options Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2014 Jan 9

PMID 24398803

Citations 8

Authors

Matthew C Konerman

Scott L Hummel

Affiliations

Soon will be listed here.

Abstract

Current guidelines vary in the recommended amount of dietary sodium intake for heart failure (HF) patients. Observational studies and the hypertension literature support the concept that sodium restriction improves HF outcomes. In contrast, several randomized controlled trials imply that dietary sodium restriction can cause harm through hypovolemia and increased neurohormonal activation. Data from hypertensive animal models and humans suggest that dietary sodium intake may need to be individually tailored based on HF severity and the physiologic response to sodium loading. Future studies must assess interactions between sodium intake, fluid intake, and diuretics to match clinical practice and improve safety. More information is needed in multiple areas, including accurate measurement of sodium intake, implementation of dietary changes in HF patients, and establishment of biomarkers that predict response to changes in sodium intake. Additional research is urgently needed to determine the true impact of the most commonly recommended self-care strategy in HF.

Citing Articles

Sodium intake and the risk of heart failure and hypertension: epidemiological and Mendelian randomization analysis.

Yuan M, Yan D, Wang Y, Qi M, Li K, Lv Z Front Nutr. 2024; 10:1263554.

PMID: 38344244 PMC: 10853369. DOI: 10.3389/fnut.2023.1263554.

Fluid and Salt Balance and the Role of Nutrition in Heart Failure.

Chrysohoou C, Mantzouranis E, Dimitroglou Y, Mavroudis A, Tsioufis K Nutrients. 2022; 14(7).

PMID: 35405998 PMC: 9002780. DOI: 10.3390/nu14071386.

Predictors of Exercise Capacity in Dilated Cardiomyopathy with Focus on Pulmonary Venous Flow Recorded with Transesophageal Eco-Doppler.

Caiati C, Argentiero A, Forleo C, Favale S, Lepera M J Clin Med. 2021; 10(24).

PMID: 34945249 PMC: 8706207. DOI: 10.3390/jcm10245954.

Effects of a Low-Salt and High-Potassium Diet on Arterial Stiffness and Left Ventricular Function in Indigenous Papuans.

Ishida A, Isotani A, Fujisawa M, Del Saz E, Okumiya K, Kimura Y J Am Heart Assoc. 2021; 10(24):e021789.

PMID: 34873920 PMC: 9075252. DOI: 10.1161/JAHA.121.021789.

The role of diet and nutrition in heart failure: A state-of-the-art narrative review.

Billingsley H, Hummel S, Carbone S Prog Cardiovasc Dis. 2020; 63(5):538-551.

PMID: 32798501 PMC: 7686142. DOI: 10.1016/j.pcad.2020.08.004.

References

McMurray J, Adamopoulos S, Anker S, Auricchio A, Bohm M, Dickstein K . ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the.... Eur J Heart Fail. 2012; 14(8):803-69. DOI: 10.1093/eurjhf/hfs105. View

Appel L, Frohlich E, Hall J, Pearson T, Sacco R, Seals D . The importance of population-wide sodium reduction as a means to prevent cardiovascular disease and stroke: a call to action from the American Heart Association. Circulation. 2011; 123(10):1138-43. DOI: 10.1161/CIR.0b013e31820d0793. View

Lloyd-Jones D, Larson M, Leip E, Beiser A, DAgostino R, Kannel W . Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002; 106(24):3068-72. DOI: 10.1161/01.cir.0000039105.49749.6f. View

Koelling T, Johnson M, Cody R, Aaronson K . Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 2005; 111(2):179-85. DOI: 10.1161/01.CIR.0000151811.53450.B8. View

Hummel S, Seymour E, Brook R, Kolias T, Sheth S, Rosenblum H . Low-sodium dietary approaches to stop hypertension diet reduces blood pressure, arterial stiffness, and oxidative stress in hypertensive heart failure with preserved ejection fraction. Hypertension. 2012; 60(5):1200-6. PMC: 3522520. DOI: 10.1161/HYPERTENSIONAHA.112.202705. View

Jablonski K, Racine M, Geolfos C, Gates P, Chonchol M, McQueen M . Dietary sodium restriction reverses vascular endothelial dysfunction in middle-aged/older adults with moderately elevated systolic blood pressure. J Am Coll Cardiol. 2012; 61(3):335-43. PMC: 3549053. DOI: 10.1016/j.jacc.2012.09.010. View

Arcand J, Steckham K, Tzianetas R, LAbbe M, Newton G . Evaluation of sodium levels in hospital patient menus. Arch Intern Med. 2012; 172(16):1261-2. DOI: 10.1001/archinternmed.2012.2368. View

Ingelsson E, Bjorklund-Bodegard K, Lind L, Arnlov J, Sundstrom J . Diurnal blood pressure pattern and risk of congestive heart failure. JAMA. 2006; 295(24):2859-66. DOI: 10.1001/jama.295.24.2859. View

Damman K, van Deursen V, Navis G, Voors A, Van Veldhuisen D, Hillege H . Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J Am Coll Cardiol. 2009; 53(7):582-588. DOI: 10.1016/j.jacc.2008.08.080. View

10.

Verdecchia P, Schillaci G, Guerrieri M, GATTESCHI C, Benemio G, Boldrini F . Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990; 81(2):528-36. DOI: 10.1161/01.cir.81.2.528. View

11.

McKie P, Schirger J, Costello-Boerrigter L, Benike S, Harstad L, Bailey K . Impaired natriuretic and renal endocrine response to acute volume expansion in pre-clinical systolic and diastolic dysfunction. J Am Coll Cardiol. 2011; 58(20):2095-103. PMC: 3835631. DOI: 10.1016/j.jacc.2011.07.042. View

12.

Alvelos M, Ferreira A, Bettencourt P, Serrao P, Pestana M, Cerqueira-Gomes M . The effect of dietary sodium restriction on neurohumoral activity and renal dopaminergic response in patients with heart failure. Eur J Heart Fail. 2004; 6(5):593-9. DOI: 10.1016/j.ejheart.2003.11.020. View

13.

Alderman M, Cohen H . Dietary sodium intake and cardiovascular mortality: controversy resolved?. Curr Hypertens Rep. 2012; 14(3):193-201. DOI: 10.1007/s11906-012-0275-6. View

14.

Boddi M, Poggesi L, Coppo M, Zarone N, Sacchi S, Tania C . Human vascular renin-angiotensin system and its functional changes in relation to different sodium intakes. Hypertension. 1998; 31(3):836-42. DOI: 10.1161/01.hyp.31.3.836. View

15.

Aliti G, Rabelo E, Clausell N, Rohde L, Biolo A, Beck-da-Silva L . Aggressive fluid and sodium restriction in acute decompensated heart failure: a randomized clinical trial. JAMA Intern Med. 2013; 173(12):1058-64. DOI: 10.1001/jamainternmed.2013.552. View

16.

Kimura G, Dohi Y, Fukuda M . Salt sensitivity and circadian rhythm of blood pressure: the keys to connect CKD with cardiovascular events. Hypertens Res. 2010; 33(6):515-20. DOI: 10.1038/hr.2010.47. View

17.

Bihorac A, Tezcan H, Ozener C, Oktay A, Akoglu E . Association between salt sensitivity and target organ damage in essential hypertension. Am J Hypertens. 2000; 13(8):864-72. DOI: 10.1016/s0895-7061(00)00253-3. View

18.

Lainscak M, Cleland J, Lenzen M, Nabb S, Keber I, Follath F . Recall of lifestyle advice in patients recently hospitalised with heart failure: a EuroHeart Failure Survey analysis. Eur J Heart Fail. 2007; 9(11):1095-103. DOI: 10.1016/j.ejheart.2007.08.001. View

19.

Scisney-Matlock M, Glazewki L, McClerking C, Kachorek L . Development and evaluation of DASH diet tailored messages for hypertension treatment. Appl Nurs Res. 2006; 19(2):78-87. DOI: 10.1016/j.apnr.2005.05.005. View

20.

Levy D, Larson M, Vasan R, Kannel W, Ho K . The progression from hypertension to congestive heart failure. JAMA. 1996; 275(20):1557-62. View