Do Inpatients with Acute Heart Failure Need a Low-Salt Diet?

Clinical Takeaway

: It’s time to reconsider sodium restriction in favor of more-typical intake.

Context

Low-sodium diets are often ordered for hospitalized patients with acute heart failure (HF) exacerbation. However, the benefits of this approach are unproven, and many patients despise these diets. A recent report from the series Things We Do For No Reason^TM summarizes the relevant data.

Key Findings

Three small, randomized trials compared restricted sodium intake (ranging from 800 mg to 1.2 g daily) with more liberal intake (3–5 g or more) in hospitalized patients with acute decompensated HF; no differences were seen in weight loss, congestion scores, or hospital readmissions.
A recent meta-analysis involving 17 trials (including the three above-noted inpatient trials plus outpatient trials) found that sodium restriction did not improve…

Reviewing Author

Daniel D. Dressler, M.D., M.Sc., M.H.M., M.A.C.P.

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel

Leadership Positions in Professional SocietiesAmerican College of Physicians, 2027 Annual Meeting Committee