Evaluating Sodium and Fluid Restrictions in Heart Failure Patients

Developments in the field of heart failure have led to increased available therapies, including medications, devices, and patient-driven interventions such as exercise and diet. In a recent review published in Progress in Cardiovascular Diseases, researchers evaluated the current state of evidence for dietary sodium and fluid restriction, two common interventions for heart failure patients.

Over the past 20 years, clinical research examining the impact of sodium restriction on outcomes for heart failure patients has grown substantially. Presently, considerable data indicates that sodium restriction does not significantly impact clinical outcomes. Current evidence has shown dietary sodium restriction provides a modest benefit for improving health-related quality of life in some, but not all, patients. The researchers indicate that sodium restriction should be implemented through individualized dietary counseling specifically tailored to the patient’s needs.

Fluid restriction is one of the most common non-pharmacological recommendations for heart failure patients; however, it remains controversial due to a lack of evidence. The researchers emphasize that this intervention should be utilized cautiously until further research and clinical study can pinpoint the potential benefits and harms of fluid restriction in this patient population.

The review ultimately concludes that there should be a greater focus on larger-scale, high-quality clinical trials that can more comprehensively inform clinical practice guidelines for sodium and fluid restriction in heart failure patients.

This research was co-authored by the CVC’s Justin Ezekowitz, MBBCh, MSc, along with Eloisa Colin-Ramirez, PhD (Universidad Anáhuac México), JoAnne Arcand, PhD, RD (Ontario Tech University), and Clara Saldarriaga, MD (Centro Cardiovascular Colombiano Clinica Santa Maria).