Salt Restriction for Heart Failure with Preserved Ejection Fraction: Does It Help?

Salt restriction in order to avoid fluid retention seems to make good sense for individuals with heart failure, but evidence supporting the practice is thin; the most recent ACC/AHA guideline recommends “avoiding excessive sodium intake” as a reasonable approach. This post hoc analysis of the TOPCAT trial, which studied spironolactone in HF with preserved systolic function (HFpEF), assessed the relationship between salt intake, measured by patient reports of using salt in their cooking, and the primary composite endpoint of cardiovascular death, HF hospitalization, and aborted sudden cardiac death among 1713 individuals (median age, 73; 50% women) with HFpEF.

Almost half the cohort (816 people) reported adding no salt to the meals they cooke…