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ACC: Low-Sodium Intervention Has Little Benefit in Heart Failure

Low-sodium diet did not reduce composite primary outcome of cardiovascular admission to hospital or ED or all-cause death

THURSDAY, April 7, 2022 (HealthDay News) — A dietary intervention to reduce sodium intake is feasible for patients with chronic heart failure but does not improve clinical outcomes, according to a study published online April 2 in The Lancet to coincide with the annual meeting of the American College of Cardiology, held from April 2 to 4 in Washington, D.C.

Justin A. Ezekowitz, M.B.B.Ch., from the University of Alberta in Edmonton, Canada, and colleagues conducted an open-label, randomized controlled trial enrolling 806 patients with chronic heart failure receiving optimally tolerated guideline-directed medical treatment at 26 sites in six countries. Participants were randomly assigned to usual care or a low-sodium diet of less than 100 mmol (<1,500 mg/day; 409 and 397 patients, respectively).

The researchers found that median sodium intake decreased from 2,286 to 1,658 mg/day from baseline to 12 months in the low-sodium group and from 2,119 to 2,073 mg/day in the usual care group. By 12 months, the primary outcome (composite of cardiovascular-related admission to hospital, cardiovascular-related emergency department visit, or all-cause death) occurred in 15 and 17 percent of patients in the low-sodium and usual care groups, respectively (hazard ratio, 0.89; 95 percent confidence interval, 0.63 to 1.26; P = 0.53). No significant differences were seen between the groups in terms of all-cause death, cardiovascular-related hospitalization, and cardiovascular-related emergency department visits. Neither group reported safety events related to the study treatment.

“The dietary intervention in this study was feasible and effective in reducing sodium intake in patients with heart failure but did not result in changes in clinical outcomes,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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