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Sodium restriction in heart failure: benefit or harm?

Abstract

OPINION STATEMENT

Current guidelines vary in the recommended amount of dietary sodium intake for heart failure (HF) patients. Observational studies and the hypertension literature support the concept that sodium restriction improves HF outcomes. In contrast, several randomized controlled trials imply that dietary sodium restriction can cause harm through hypovolemia and increased neurohormonal activation. Data from hypertensive animal models and humans suggest that dietary sodium intake may need to be individually tailored based on HF severity and the physiologic response to sodium loading. Future studies must assess interactions between sodium intake, fluid intake, and diuretics to match clinical practice and improve safety. More information is needed in multiple areas, including accurate measurement of sodium intake, implementation of dietary changes in HF patients, and establishment of biomarkers that predict response to changes in sodium intake. Additional research is urgently needed to determine the true impact of the most commonly recommended self-care strategy in HF.

Authors+Show Affiliations

Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24398803

Citation

Konerman, Matthew C., and Scott L. Hummel. "Sodium Restriction in Heart Failure: Benefit or Harm?" Current Treatment Options in Cardiovascular Medicine, vol. 16, no. 2, 2014, p. 286.
Konerman MC, Hummel SL. Sodium restriction in heart failure: benefit or harm? Curr Treat Options Cardiovasc Med. 2014;16(2):286.
Konerman, M. C., & Hummel, S. L. (2014). Sodium restriction in heart failure: benefit or harm? Current Treatment Options in Cardiovascular Medicine, 16(2), p. 286. doi:10.1007/s11936-013-0286-x.
Konerman MC, Hummel SL. Sodium Restriction in Heart Failure: Benefit or Harm. Curr Treat Options Cardiovasc Med. 2014;16(2):286. PubMed PMID: 24398803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sodium restriction in heart failure: benefit or harm? AU - Konerman,Matthew C, AU - Hummel,Scott L, PY - 2014/1/9/entrez PY - 2014/1/9/pubmed PY - 2014/1/9/medline SP - 286 EP - 286 JF - Current treatment options in cardiovascular medicine JO - Curr Treat Options Cardiovasc Med VL - 16 IS - 2 N2 - OPINION STATEMENT: Current guidelines vary in the recommended amount of dietary sodium intake for heart failure (HF) patients. Observational studies and the hypertension literature support the concept that sodium restriction improves HF outcomes. In contrast, several randomized controlled trials imply that dietary sodium restriction can cause harm through hypovolemia and increased neurohormonal activation. Data from hypertensive animal models and humans suggest that dietary sodium intake may need to be individually tailored based on HF severity and the physiologic response to sodium loading. Future studies must assess interactions between sodium intake, fluid intake, and diuretics to match clinical practice and improve safety. More information is needed in multiple areas, including accurate measurement of sodium intake, implementation of dietary changes in HF patients, and establishment of biomarkers that predict response to changes in sodium intake. Additional research is urgently needed to determine the true impact of the most commonly recommended self-care strategy in HF. SN - 1092-8464 UR - https://www.unboundmedicine.com/medline/citation/24398803/full_citation L2 - https://dx.doi.org/10.1007/s11936-013-0286-x DB - PRIME DP - Unbound Medicine ER -