Does Salt Reduction Actually Benefit Heart Failure Patients?

Results of a recent study call into question the idea that limiting salt intake is beneficial to patients with heart failure.

Current management of patients with heart failure often includes the advice to reduce salt intake, although the benefits of this reduction remain uncertain.

To explore this association, the researchers conducted a systematic review of 9 studies involving 479 participants. The primary outcomes of interest were cardiovascular-associated mortality, all-cause mortality, and adverse events, such as stroke and myocardial infarction, and the secondary outcomes were hospitalization, length of inpatient stay, change in New York Heart Association (NYHA) functional class, adherence to dietary low-salt intake, and changes in blood pressure.

Overall, none of the studies had sufficient data on the primary outcomes, while 2 reported that the NYHA functional class was not improved by reduction of salt intake and 2 reported that the NYHA functional class was improved.

“Despite broad advocacy, uncertainty remains about the robustness of advice to reduce salt intake in patients with heart failure,” they concluded.

“A paucity of robust high-quality evidence was available to support or refute current guidance. Well-designed, well-described, and adequately powered studies are needed to reduce uncertainty about the use of this intervention.”

—Michael Potts

Reference:

Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced salt intake for heart failure [Published online November 5, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4673.