Benefit of low salt diet for uncertain heart failure
Benefit of low salt diet for uncertain heart failure
(Reuters Health) - Although many doctors recommend heart failure patients follow a low-salt diet to help minimize complications, a new study suggests there is no high-quality evidence to support this recommendation.
"We still do not have a clear understanding of the mechanisms that can link salt intake with heart failure," said the study's lead author, Dr. Kamal Mahtani, of the University of Oxford in the United Kingdom.
But the results still do not mean that doctors and patients should abandon recommendations to reduce salt intake, said Dr. Clyde Yancy, of Northwestern University, Feinberg School of Medicine in Chicago.
"I am sure that there will be those who declare: 'Hallelujah! I can have a big bag of chips tonight! "But do not do it," said Yancy, author of an accompanying editorial, in an email. "The consequences will be the same as before, you will get sick."
Restricting salt or sodium in the diet has been a cornerstone of lifestyle recommendations for patients with heart failure, and that should not change because too much salt causes fluid retention that a heart weakened by heart failure can not. drive, said Yancy.
"Reckless consumption of pizza, pickles, French fries and other very salty foods will lead to a worsening of heart failure, sometimes enough to require hospitalization," Yancy said. "So yes, sodium restriction in heart failure is still necessary."
But the study also highlights that scientists do not know with certainty what level of salt restriction is ideal or whether this can vary for different types of patients, Yancy added. More research is needed to answer this question and provide patients with better guidance in the future.
For the new study, Mahtani and his colleagues examined data from nine previously published studies involving a total of 479 patients. None of these studies provided sufficient data to determine whether a low salt diet could be associated with a lower risk of death from cardiovascular causes such as heart attacks or strokes.
"Many of the guidelines seem to vary in the exact advice they give to patients with heart failure when it comes to reducing salt intake," Mahtani said in an email. "Our research highlights a shortage of robust, high-quality evidence available to support or disprove the current guidance."
High salt intake is an important risk factor for high blood pressure, which can lead to heart disease, heart attacks and strokes.
Heart failure occurs when the heart muscle is too weak to effectively pump enough blood through the body. Symptoms may include fatigue, weight gain due to fluid retention, difficulty breathing and coughing or wheezing. Medications can help strengthen the heart and minimize the accumulation of fluids in the body.
Coronary artery disease, which develops when fatty deposits build up in the arteries and reduce blood flow, is a common cause of heart failure. Frequently, patients are advised to reduce salt intake to help lower their blood pressure and reduce tension in clogged arteries.
In the study, the researchers examined several potential impacts of a low-salt diet in patients with heart failure and found no decisive connection.
For example, the number of repeat hospitalizations for acute illness was similar, regardless of the salt intake in patients with heart failure, according to the analysis.
Salt intake also does not seem to influence the frequency or severity of heart failure symptoms.
One drawback of the analysis is that the smaller studies varied in the way they measured salt intake and evaluated the symptoms and outcomes of heart failure, making it difficult to group the results in all these studies to get a clearer picture. of the impact of a diet low in salt, the authors point out.
SOURCE: bit.ly/2F8Mzvq Y bit.ly/2FjRHgD JAMA Internal Medicine, online November 5, 2018.
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