Limiting salt intake is believed to be a key component of heart failure treatment. However, excessive salt restriction may exacerbate the therapeutic effect of patients with heart failure, a common form of heart disease, a study has found.
Most heart failure guidelines recommend salt restriction. However, the optimal limiting range (<1.5 g to <3 g/day) and its effect are not clear in patients with heart failure with preserved ejection fraction. This is because this part has often been excluded from related studies. Preserved ejection fraction, which accounts for half of all heart failure cases, occurs when the lower left ventricle does not fill enough with blood and the amount of blood flowing into the body decreases.
To explore the link between salt intake and salt intake, the research team secondarily analyzed data from 1713 patients with heart failure over the age of 50 in the Top Cat trial. Participants scored 0 (no salt at all), 1 (⅛ tsp), 2 (¼ tsp), 3 (½+ tsp) was scored.
The participants’ health was then monitored for an average of three years. The primary endpoint consisted of death due to cardiovascular disease or hospital admission due to heart failure, and heart attack. Secondary endpoints included deaths from all causes, deaths from cardiovascular disease, and hospital admissions for heart failure.
As a result of the study, half of the participants (816) had a cooking salt score of 0. More than half of them were male (56%), and most were white (81%). They weighed significantly more and had lower diastolic blood pressure than those with a salt score of 0 or higher. They also had more frequent hospitalizations for heart failure and were more likely to develop type 2 diabetes. Kidney function was also worse. Medications were taken to control heart failure, and left ventricular ejection fraction, an indicator of how well the heart pumps blood, decreased.
Those with a salt score higher than zero had a significantly lower risk of the primary endpoint than the zero-score group. Because the risk of being hospitalized for heart failure was low. Also, people under the age of 70 were significantly more likely to benefit from adding salt to their dishes than those over 70.
Low sodium intake has been associated with a reduced risk of cardiovascular disease in the average person and in hypertensive patients. However, the researchers say limiting salt intake to control heart failure is not so simple. The study suggests that low sodium intake does not alleviate fluid retention in people with ejection fraction-preserving heart failure.
In other words, ‘excessive restriction of salt intake (ejection-preserving heart failure) can harm patients and is associated with a worse prognosis. Physicians should reconsider giving this advice to their patients,’ the team concludes.
The study was published online in the journal Heart. Original title ‘Salt restriction and risk of adverse outcomes in heart failure with preserved ejection fraction’.
Reporter Lee Bo-hyun [email protected]
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