Higher salt preference in heart failure patients

Souza, Juli Thomaz de; Matsubara, Luiz Shiguero; Menani, José Vanderlei; Matsubara, Beatriz Bojikian; Johnson, Alan Kim; Gobbi, Juliana Irani Fratucci De

doi:10.1016/j.appet.2011.09.021

Cited by 23 publications

(16 citation statements)

References 40 publications

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“…71 Since salt taste loss is pronounced in older adults, and older adults with HF represent a population in which dietary adherence is critical to reduce adverse outcomes, therapeutic interventions that target salt taste affinity in older adults have the potential for tremendous impact in the management of older adult patients with HF. We hypothesize that older adults with HF may benefit from several weeks of sodium restriction that induces a shift in salt taste affinity and yields subsequent dietary adherence (Figure 2).…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Dietary Interventions for Heart Failure in Older Adults: Re-Emergence of the Hedonic Shift

Wessler

Hummel

Maurer

2014

Progress in Cardiovascular Diseases

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Dietary non-adherence to sodium restriction is an important contribution to heart failure (HF) symptom burden, particularly in older adults. While knowledge, skills, and attitudes towards sodium restriction are important, sodium intake is closely linked to the ability to taste salt. The ‘hedonic shift’ occurs when sodium restriction induces changes in an individual’s salt taste that lower subsequent salt affinity. Older adults often have compromised salt taste and higher dietary salt affinity due to age-related changes. Older HF patients may have additional loss of salt taste and elevated salt appetite due to comorbid conditions, medication use, and micronutrient or electrolyte abnormalities, creating a significant barrier to dietary adherence. Induction of the hedonic shift has the potential to improve long-term dietary sodium restriction and significantly impact HF outcomes in older adults.

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Section: Therapeutic Implicationsmentioning

confidence: 99%

Dietary Interventions for Heart Failure in Older Adults: Re-Emergence of the Hedonic Shift

Wessler

Hummel

Maurer

2014

Progress in Cardiovascular Diseases

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“…[30] In addition, compared to healthy individuals, patients with HF have a strong predilection for salt-rich foods. [31] This increased appetite for sodium occurs as a symptom of HF, mediated largely by hormones in the renin-angiotensin-aldosterone system, [32] and is another factor responsible for poor adherence; therefore, it should be taken into account in the development of interventions.…”

Section: Published By Sciedu Pressmentioning

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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“…Increased salt intake is also associated with oxidative stress (20). Furthermore, studies also show increased salt preference in heart failure patients, suggesting another link between salt intake and cardiovascular disease (9,22).…”

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confidence: 99%

Mineralocorticoid receptor in the NTS stimulates saline intake during fourth ventricular infusions of aldosterone

Koneru

Bathina

Cherry

et al. 2014

American Journal of Physiology-Regulatory, Integrative and Comp

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Koneru B, Bathina CS, Cherry BH, Mifflin SW. Mineralocorticoid receptor in the NTS stimulates saline intake during fourth ventricular infusions of aldosterone. Am J Physiol Regul Integr Comp Physiol 306: R61-R66, 2014. First published November 20, 2013 doi:10.1152/ajpregu.00434.2013.-The purpose of this study was to determine whether neurons within the nucleus tractus solitarius (NTS) that express the mineralocorticoid receptor (MR) play a role in aldosterone stimulation of salt intake. Adult Wistar-Kyoto (WKY) rats received microinjections into the NTS of a short-hairpin RNA (shRNA) for the MR, to site specifically reduce levels of the MR by RNA interference (shRNA; n ϭ 9) or scrambled RNA as a control (scRNA; n ϭ 8). After injection of the viral construct, aldosteronefilled osmotic minipumps were implanted subcutaneously and connected to a cannula extending into the fourth ventricle to infuse aldosterone at a rate of 25 ng/h. Before and after surgeries, rats had ad libitum access to normal sodium (0.26%) rat chow and two graduated drinking bottles filled with either distilled water or 0.3 M NaCl. Before the surgeries, basal saline intake was 1.6 Ϯ 0.6 ml in the scRNA group and 1.56 Ϯ 0.6 ml in the shRNA group. Twenty-four days postsurgery, saline intake was elevated to a greater extent in the scRNA group (5.9 Ϯ 1.07 ml) than in the shRNA group (2.41 Ϯ 0.6 ml). Post mortem immunohistochemistry revealed a significant reduction in the number of NTS neurons exhibiting immunoreactivity for MR in shRNA-injected rats (23 Ϯ 1 cells/section) versus scRNAinjected rats (33 Ϯ 2 cells/section; P ϭ 0.008). shRNA did not alter the level of 11-␤-hydroxysteroid dehydrogenase type II (HSD2) protein in the NTS as judged by the number of HSD2 immunoreactive neurons. These results suggest that fourth ventricular infusions of aldosterone stimulate saline intake, and that this stimulation is at least in part mediated by hindbrain NTS neurons that express MR.

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Higher salt preference in heart failure patients

Cited by 23 publications

References 40 publications

Dietary Interventions for Heart Failure in Older Adults: Re-Emergence of the Hedonic Shift

Dietary Interventions for Heart Failure in Older Adults: Re-Emergence of the Hedonic Shift

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

Mineralocorticoid receptor in the NTS stimulates saline intake during fourth ventricular infusions of aldosterone

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