Limiting your salt intake may not help your health?
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Limiting your salt intake may not help your health?
Although salt restriction is considered an important part of the treatment of heart failure, a study published in the journal Heart shows that restricting salt intake too severely may change the situation in those with the common condition worse.
The findings suggest that the most vulnerable groups are young adults and people of black and other ethnic origin.
Limitation of salt intake is often recommended in heart failure guidelines, but the ideal range (from less than 1.5 g to less than 3 g per day) and its effect on patients with heart failure with preserved ejection fraction are unclear because these types of patients Often excluded from relevant studies.
Heart failure with preserved ejection fraction, which accounts for nearly half of all heart failure cases, occurs when the left ventricle, the lower left chamber of the heart, cannot fill properly with blood (diastole), resulting in less blood being pumped into the body.
The researchers conducted a secondary analysis of data from 1,713 TOPCAT trial participants aged 50 years or older with heart failure with preserved ejection fraction to further investigate the link between salt consumption and heart failure.
This is a phase III, randomized, double-blind, placebo-controlled study to find out whether the drug spironolactone is effective in treating symptomatic heart failure with preserved ejection fraction.
Participants were asked how much salt they often added when cooking staple foods, such as rice, noodles , and potatoes; soups; meat; and vegetables, and this was recorded. 0 (none); 1 (⅛ tsp); 2 (¼ tsp); and 3 (½+ tsp).
Their health was then monitored for an average of 3 years for the primary endpoint, a composite of cardiovascular death or hospital admission for heart failure plus cardiac arrest.
Secondary outcomes were death from any cause and death from cardiovascular disease and hospital admissions for heart failure.
About half of the participants (816) had zero cooking salt: more than half of them were men (56%) and most were Caucasian (81%).
They gained significantly more weight and had lower diastolic blood pressure (70 mmHg) compared to those who cooked above zero salt (897).
They were also more often admitted to hospital for heart failure, were more likely to have type 2 diabetes, had poorer kidney function, were taking medications to control heart failure, and had a decreased left ventricular ejection fraction (lower cardiac output).
Participants with a cooking salt above zero had a significantly lower risk of the primary endpoint than those with a score of zero, largely because they were less likely to be hospitalized for heart failure.
But they were no less likely to die from any cause or from cardiovascular disease than those with zero cooking salt.
People aged 70 or younger were significantly more likely than those over 70 to benefit from adding salt to cooking for the primary endpoint and hospital admissions for heart failure.
Likewise, blacks and other races appear to benefit more from adding salt to cooking than whites, albeit in small numbers.
Gender, previous admission for heart failure, and use of heart failure medication were not associated with increased risk of measurements and cooking salt.
This is an observational study, and as such, cannot establish cause.
The researchers acknowledged that not all relevant data from the TOPCAT trial were available, and that cooking salt was self-reported.
And reverse causation cannot be ruled out, whereby people with poorer health may be advised to further limit their salt intake.
In the general population and in people with high blood pressure, lower salt intake is generally associated with lower blood pressure and lower risk of cardiovascular disease.
It is thought to reduce fluid retention and the triggering of hormones involved in blood pressure regulation.
But limiting salt intake to control heart failure is not so simple, the researchers said. It may prompt intravascular volume contraction, which in turn may reduce congestion and the requirement for water tablets to relieve fluid retention.
But their findings showed that the amount of plasma in the blood — an indicator of congestion — was not significantly associated with cooking salt, suggesting that low sodium intake did not alleviate fluid retention in heart failure patients with preserved ejection fraction, the researchers pointed out.
“Overly strict dietary salt restriction may harm patients with [EF-preserving heart failure] and is associated with worse outcomes. Physicians should reconsider this recommendation to patients,” they concluded.
Reference:
https://heart.bmj.com/content/108/17/1377
Limiting your salt intake may not help your health?
(source:internet, reference only)
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