Review Questions Wisdom of Limiting Salt Intake in Heart Failure

[MeSci]

Something that may concern quite a few ME sufferers. Personally I need a lot of salt, and so do some others.

Review Questions Wisdom of Limiting Salt Intake in Heart Failure

By Kelly Young

Edited by

- David G. Fairchild, MD, MPH

It is not clear whether lowering dietary salt intake actually helps patients with heart failure, according to a review in JAMA Internal Medicine.

Researchers reviewed nine trials that randomized nearly 500 patients with heart failure to restricted sodium intake or to a control group. There was little evidence supporting a low-sodium diet in terms of cardiovascular and all-cause mortality and cardiovascular-associated events. Two of the trials reported improvements in NYHA functional class with a restricted-sodium diet.

Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, says that this is "an important study for what it doesn't find, which is a lack of evidence to support salt restriction.

For all the burden we have imposed on patients with this strategy, it turns out we have too little evidence to support the practice."

Link(s):
JAMA Internal Medicine review article (Free) http://response.jwatch.org/t?ctl=44D29:5FF9B588B7CB016CB2023874240CB362D2B71D9A95FA21D3&

Background: NEJM Journal Watch Cardiology coverage of sodium restriction and heart failure (Your NEJM Journal Watch registration required) http://response.jwatch.org/t?ctl=44D2A:5FF9B588B7CB016CB2023874240CB362D2B71D9A95FA21D3&

 

[Mij]

I've improved with more salt intake

NMH and POTS are most often treated with a combination of increased salt and water intake. The increased salt and water help ensure that the blood vessels are filled better, and that the heart receives an adequate amount of blood even during upright posture. Drinking a glass of water before venturing out often helps people tolerate the activity. We recommend at least 2 liters of fluid per day. Our patients who drink fluids regularly throughout the day seem to do better than those who don't take this task seriously. Keep in mind that prolonged periods of sleeping (more than 12 hours) may interfere with the ability to keep up with fluid needs. We recommend drinking fluids every 2 hours throughout the day. As a result, it is important to have easy access to fluids at work or at school. For those who have been on a low salt intake we recommend an increase in the amount of salt they add to their food. The Appendix to this document contains a list of high salt foods. For some mildly affected individuals, an increased intake of salt and fluids may be all that is needed. Most of those with more severe symptoms require one of several medications in addition to the increased salt and fluid intake. The increased salt and fluid intake should be continued regardless of which of these medications is added.

 

[MeSci]

Important to note that ACE inhibitors reduce the amount of salt in the body, as I found out rather horrendously. (Had to be rushed to hospital with blood sodium of about 113!)

 

[Sean]

I think Klimas says moderately increased salt intake is not a bad thing for CFS patients.

 

[Alvin]

Low blood pressure should lower the risk of a heart attack. The exact reasons why i have forgotten.
That said blood pressure is also controlled by the autonomic nervous system and in some diseases of its dysfunction salt and increased blood pressure may be beneficial. And as a slight aside in Parkinsons patients often blood pressure gets lower over time due to autonomic dysfunction.