Patients with heart failure are often recommended to restrict sodium intake in their diet, however, current scientific evidence does not support limiting dietary sodium to improve clinical outcomes. In this secondary analysis of the SODIUM-HF trial, published in the Journal of Cardiac Failure, researchers investigated the link between baseline dietary sodium intake and change at 6 months, with patient outcomes (cardiovascular hospitalizations, emergency department visits, and all-cause death) at 12 months (the original follow-up) and extended it to 24 months for a longer assessment of impact.
Of the 792 participants included in this secondary analysis, baseline sodium intake was less than 1500 mg/day in 158 (19.9%), 1501–3000 mg/day in 448 (56.5%), and more than 3000 mg/day in 186 (23.4%). Higher baseline dietary sodium intake was linked to several factors, including recruitment region (notably Canada), higher calorie consumption, and higher body mass index. The researchers found that there was no association between dietary sodium intake at baseline on clinical outcomes in patients with heart failure over a period of two years. Furthermore, they observed no relationship between the overall extent of sodium reduction and clinical outcomes, and there were no evident benefits (or harm) associated with dietary sodium reduction over two years.
The researchers also emphasize the key role of adherence in a dietary intervention study, particularly since only 33.7% of patients who were alive at 6 months achieved less than 1500 mg sodium levels at 6 months. For this reason, they recommend further investigation focused on sodium reduction in heart failure patients who meet the targeted dietary sodium-reduction level.
This research was conducted on behalf of the SODIUM-HF Investigators, and CVC co-authors include Justin Ezekowitz, MBBCh, MSc, Sunjidatul Islam, MBBS, MSC, Wendimagegn Alemayehu, PhD, and Finlay McAlister, MD, MSc.
