Role of dietary sodium restriction in chronic heart failure: systematic review and meta-analysis
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Published:2023-06-30
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Volume:
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ISSN:1861-0684
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Container-title:Clinical Research in Cardiology
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language:en
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Short-container-title:Clin Res Cardiol
Author:
Urban Szymon, Fułek Michał, Błaziak MikołajORCID, Fułek Katarzyna, Iwanek Gracjan, Jura Maksym, Grzesiak Magdalena, Szymański Oskar, Stańczykiewicz Bartłomiej, Ptaszkowski Kuba, Zymlinski Robert, Ponikowski Piotr, Biegus Jan
Abstract
Abstract
Background
Dietary sodium restriction remains a guidelines-approved lifestyle recommendation for chronic heart failure (CHF) patients. However, its efficacy in clinical outcome improvement is dubious.
Objective
The study evaluated whether dietary sodium restriction in CHF reduces clinical events.
Methods
We performed a systematic review of the following databases: Academic Search Ultimate, ERIC, Health Source Nursing/Academic Edition, MEDLINE, Embase, Clinicaltrials.gov and Cochrane Library (trials) to find studies analysing the impact of sodium restriction in the adult CHF population. Both observational and interventional studies were included. Exclusion criteria included i.e.: sodium consumption assessment based only on natriuresis, in-hospital interventions or mixed interventions—e.g. sodium and fluid restriction in one arm only. The review was conducted following PRISMA guidelines. Meta-analysis was performed for the endpoints reported in at least 3 papers. Analyses were conducted in Review Manager (RevMan) Version 5.4.1.
Results
Initially, we screened 9175 articles. Backward snowballing revealed 1050 additional articles. Eventually, 9 papers were evaluated in the meta-analysis. All-cause mortality, HF-related hospitalizations and the composite of mortality and hospitalisation were reported in 8, 6 and 3 articles, respectively. Sodium restriction was associated with a higher risk of the composite endpoint (OR 4.12 [95% CI 1.23–13.82]) and did not significantly affect the all-cause mortality (OR 1.38 [95% CI 0.76–2.49]) or HF hospitalisation (OR 1.63 [95% CI 0.69–3.88]).
Conclusions
In a meta-analysis, sodium restriction in CHF patients worsened the prognosis in terms of a composite of mortality and hospitalizations and did not influence all-cause mortality and HF hospitalisation rate.
Graphical abstract
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,General Medicine
Reference45 articles.
1. Yancy CW (2016) The Uncertainty of sodium restriction in heart failure: we can do better than this. JACC Heart Fail 4(1):39–41. https://doi.org/10.1016/J.JCHF.2015.11.005 2. Gupta D, Georgiopoulou VV, Kalogeropoulos AP, Dunbar SB, Reilly CM, Sands JM, Fonarow GC, Jessup M, Gheorghiade M, Yancy C, Butler J (2012) Dietary sodium intake in heart failure. Circulation 126(4):479–485. https://doi.org/10.1161/CIRCULATIONAHA.111.062430 3. Ezekowitz JA, Colin-Ramirez E, Ross H, Escobedo J, Macdonald P, Troughton R, Saldarriaga C, Alemayehu W, McAlister FA, Arcand JA, Atherton J, Doughty R, Gupta M, Howlett J, Jaffer S, Lavoie A, Lund M, Marwick T, McKelvie R, Moe G, Pandey AS, Porepa L, Rajda M, Rheault H, Singh J, Toma M, Virani S, Zieroth S, Ezekowitz J, McAlister F, Pandey AS (2022) Reduction of dietary sodium to less than 100 Mmol in heart failure (SODIUM-HF): an international, open-label, randomized, controlled trial. Lancet 399(10333):1391–1400. https://doi.org/10.1016/S0140-6736(22)00369-5 4. Chaney E, Shaw A (2010) Pathophysiology of fluid retention in heart failure. Contrib Nephrol 164:46–53. https://doi.org/10.1159/000313720 5. van der Wal MHL, Jaarsma T, Moser DK, Veeger NJGM, van Gilst WH, van Veldhuisen DJ (2006) Compliance in heart failure patients: the importance of knowledge and beliefs. Eur Heart J 27(4):434–440. https://doi.org/10.1093/EURHEARTJ/EHI603
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