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Dietary sodium adherence is poor in chronic heart failure patients.
J Card Fail 2015; 21(4):323-9JC

Abstract

BACKGROUND

We sought to determine the rates and predictors of dietary sodium restriction and to evaluate the reliability of 24-hour urine collection as a tool to estimate dietary sodium intake in heart failure (HF) patients.

METHODS AND RESULTS

We evaluated the 24-hour urinary sodium excretion of 305 outpatients with HF and reduced ejection fraction who were educated on following a <2 g sodium diet. The mean sodium excretion according to a single sample from each participant was 3.15 ± 1.58 g, and 23% were adherent to the <2 g recommendation. One hundred sixty-eight participants provided 2 samples with urinary creatinine excretion within normative range. Averaging both resulted in a mean sodium excretion of 3.21 ± 1.20 g and lower adherence rates to the <2-gram diet: 14% versus 23% (P = .019). Multivariate logistic regression showed only male sex and higher body mass index (BMI) to be associated with nonadherence (male: odds ratio [OR] 2.20, 95% confidence interval [CI] 1.25-3.88; 1 unit BMI: OR 1.05, 95% CI 1.01-1.10). Bland-Altman plots of urinary sodium and creatinine showed poor reproducibility between samples.

CONCLUSIONS

In this chronic HF population, sodium consumption probably exceeds recommended amounts, particularly in men and those with higher BMI. Urine analyses were not highly reproducible, suggesting variation in both diet and urine collection.

Authors+Show Affiliations

OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital, Columbus, Ohio. Electronic address: anupambasuray@gmail.com.Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio; Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio.Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio.Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.Department of Psychology, Kent State University, Kent, Ohio.Summa Health System, Akron City Hospital, Akron, Ohio.Division of Cardiology, Department of Internal Medicine, University Hospital, Salt Lake City, Utah.Department of Psychology, Kent State University, Kent, Ohio.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25576680

Citation

Basuray, Anupam, et al. "Dietary Sodium Adherence Is Poor in Chronic Heart Failure Patients." Journal of Cardiac Failure, vol. 21, no. 4, 2015, pp. 323-9.
Basuray A, Dolansky M, Josephson R, et al. Dietary sodium adherence is poor in chronic heart failure patients. J Card Fail. 2015;21(4):323-9.
Basuray, A., Dolansky, M., Josephson, R., Sattar, A., Grady, E. M., Vehovec, A., ... Hughes, J. W. (2015). Dietary sodium adherence is poor in chronic heart failure patients. Journal of Cardiac Failure, 21(4), pp. 323-9. doi:10.1016/j.cardfail.2014.12.016.
Basuray A, et al. Dietary Sodium Adherence Is Poor in Chronic Heart Failure Patients. J Card Fail. 2015;21(4):323-9. PubMed PMID: 25576680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary sodium adherence is poor in chronic heart failure patients. AU - Basuray,Anupam, AU - Dolansky,Mary, AU - Josephson,Richard, AU - Sattar,Abdus, AU - Grady,Ellen M, AU - Vehovec,Anton, AU - Gunstad,John, AU - Redle,Joseph, AU - Fang,James, AU - Hughes,Joel W, Y1 - 2015/01/07/ PY - 2014/05/27/received PY - 2014/12/11/revised PY - 2014/12/29/accepted PY - 2015/1/11/entrez PY - 2015/1/13/pubmed PY - 2016/1/8/medline KW - Sodium KW - compliance KW - diet KW - salt SP - 323 EP - 9 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 21 IS - 4 N2 - BACKGROUND: We sought to determine the rates and predictors of dietary sodium restriction and to evaluate the reliability of 24-hour urine collection as a tool to estimate dietary sodium intake in heart failure (HF) patients. METHODS AND RESULTS: We evaluated the 24-hour urinary sodium excretion of 305 outpatients with HF and reduced ejection fraction who were educated on following a <2 g sodium diet. The mean sodium excretion according to a single sample from each participant was 3.15 ± 1.58 g, and 23% were adherent to the <2 g recommendation. One hundred sixty-eight participants provided 2 samples with urinary creatinine excretion within normative range. Averaging both resulted in a mean sodium excretion of 3.21 ± 1.20 g and lower adherence rates to the <2-gram diet: 14% versus 23% (P = .019). Multivariate logistic regression showed only male sex and higher body mass index (BMI) to be associated with nonadherence (male: odds ratio [OR] 2.20, 95% confidence interval [CI] 1.25-3.88; 1 unit BMI: OR 1.05, 95% CI 1.01-1.10). Bland-Altman plots of urinary sodium and creatinine showed poor reproducibility between samples. CONCLUSIONS: In this chronic HF population, sodium consumption probably exceeds recommended amounts, particularly in men and those with higher BMI. Urine analyses were not highly reproducible, suggesting variation in both diet and urine collection. SN - 1532-8414 UR - http://www.unboundmedicine.com/medline/citation/25576680/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(14)01369-4 DB - PRIME DP - Unbound Medicine ER -