Dietary Sodium Intake in Heart Failure

Gupta, Divya; Georgiopoulou, Vasiliki V.; Καλογερόπουλος, Ανδρέας; Dunbar, Sandra B.; Reilly, Carolyn Miller; Sands, Jeff M.; Fonarow, Gregg C.; Jessup, Mariell; Gheorghiade, Mihai; Yancy, Clyde W.; Butler, Javed

doi:10.1161/circulationaha.111.062430

Cited by 119 publications

(96 citation statements)

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“…Although HF guidelines are inconsistent in the strength of their recommendation regarding the need for a strict sodium restriction of 2000 mg (or less) for all HF patients [6,7], sodium restriction remains important in the management of heart failure [39].…”

Section: Discussionmentioning

confidence: 99%

Comparison of self-care behaviors of heart failure patients in 15 countries worldwide

Jaarsma

Strömberg

Gal

et al. 2013

Patient Education and Counseling

229

190

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This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited.

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Section: Discussionmentioning

confidence: 99%

Comparison of self-care behaviors of heart failure patients in 15 countries worldwide

Jaarsma

Strömberg

Gal

et al. 2013

Patient Education and Counseling

229

190

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“…[2] Decompensated HF requires immediate institution of therapy and subsequent hospitalization. At hospital admission, these patients predominantly exhibit congestive manifestations, [3,4] with hypervolemia accounting for 80.7% of hospitalizations due to decompensated HF. [5] Almost 50% of patients hospitalized with HF are readmitted within 90 days after hospital discharge and mortality rates increase with each readmission of these patients.…”

Section: Introductionmentioning

confidence: 99%

“…[6] In view of the association between excessive sodium intake and fluid retention, restricted salt intake is the nonpharmacological self-care measure most commonly prescribed to patients with HF. [4,7,8] Despite recurring efforts by healthcare providers to advise patients of the risks of elevated sodium intake, poor treatment adherence or nonadherence has been identified as one of the leading precipitating factors of HF decompensation. [7,[9][10][11] Data from the literature indicating that nonadherence is among the major precipitating factors of decompensation.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, barriers and attitudes toward dietary sodium in patients with decompensated heart failure

Barilli

d’Almeida²,

Trojahn³

et al. 2017

JNEP

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Background and objective: Nonadherence to sodium restriction is one of the main precipitating factors of heart failure (HF) decompensation. The three-subscale Dietary Sodium Restriction Questionnaire (DSRQ) enables evaluation of factors that can interfere with adherence. The objective of this study was to assess knowledge, barriers, and attitudes of patients with decompensated HF toward dietary sodium, by comparing those hospitalized for decompensation due to dietary nonadherence (alone or with medication nonadherence) versus those admitted for decompensation due to other causes. Methods: Cross-sectional study carried out at the emergency departments of two public hospitals in Southern Brazil between 2013 and 2014. The sample included patients admitted for decompensated HF. Patients were divided into two groups: decompensation due to nonadherence to diet (alone or with medication nonadherence) and other causes. Results: A total of 225 patients were included (mean age 66 ± 12 years). Patients exhibited a high degree of knowledge about sodium restriction (up to 50% achieved 40 of 45 points). The opinions of family and health professionals influenced adherence. The main barriers to adherence concerned palatability and dietary preferences. When compared to patients admitted for other causes, those decompensated due to nonadherence had lower ejection fraction (p = .004) and higher Perceived Behavioral Control subscale scores (p = .009). Conclusions: Patients have a high level of knowledge about sodium restriction. The opinion of significant others affects adherence. Nonadherent patients appeared to be more severely ill and endorsed a greater number of barriers that prevent adequate behavior. Some factors-particularly the taste of foods and patients' dietary preferences -may justify the high prevalence of nonadherence.

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“…While restricting salt intake is established practice in the management of heart failure, the evidence remains limited to observational studies and small randomised controlled trials of salt restriction, often with additional therapeutic interventions. [17][18][19][20] Given the lack of robust evidence, it is not surprising that, despite being recommended by all current clinical guidelines, there is no consensus on what level of salt restriction would be appropriate. However, restricting salt intake to 5 g/day, levels recommended by the World Health Organization (WHO) for the general population, is a safe, practical and modest intervention, likely to be of benefit and with no evidence of harm.…”

Section: Salt Restriction and Heart Failurementioning

confidence: 99%

“…> 24-h sodium excretion = concentration of sodium in urine (mmol/L) × urinary volume (L/day) > To convert from mmol to g divide by 17 diuretics will require judicious monitoring of fluid balance when implementing a low salt diet, and adjustment of diuretic therapy may be necessary to ensure that they do not become fluid depleted.…”

Section: Key Pointsmentioning

confidence: 99%

The health impacts of dietary sodium and a low-salt diet

Suckling

Swift

2015

Clinical Medicine

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High salt intake is now endemic worldwide. It contributes to the generation and maintenance of high blood pressure, which is now the biggest risk factor for global disease. There is now compelling evidence to support salt reduction in hypertensives and a substantial body of evidence to support salt reduction in the general population to reduce risk of death from cardiovascular disease. In specific diseases such as heart failure and chronic kidney disease, guidelines support the World Health Organization target for reduced salt intake at 5 g daily. Achieving a diet that is lower in salt has challenges, but is more likely to be achieved through salt reduction strategies particularly focused on processed food and through educational programs. To be effective, these interventions require collaboration between industry, health agencies and governments.

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Dietary Sodium Intake in Heart Failure

Cited by 119 publications

References 50 publications

Comparison of self-care behaviors of heart failure patients in 15 countries worldwide

Comparison of self-care behaviors of heart failure patients in 15 countries worldwide

Knowledge, barriers and attitudes toward dietary sodium in patients with decompensated heart failure

The health impacts of dietary sodium and a low-salt diet

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