Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?

Paterna, Salvatore; Parrinello, Giovanni; Fasullo, Sergio; Sarullo, Filippo M.; Pasquale, Pietro Di

doi:10.1042/cs20070193

Cited by 203 publications

(168 citation statements)

References 46 publications

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“…In addition, there was a high proportion (33.9%) of exclusions, mainly due to inadequate urine collections. In the Cochrane meta-analysis of the randomized trials, 14 one of these trials in heart failure 17 should not have been included because the participants were severely salt-and water-depleted due to aggressive diuretics therapy (furosemide 250-500 mg twice daily). The optimal salt intake is not clear, at present, but there is no doubt that salt reduction is mandatory in any country in which salt consumption is extremely high, such as Japan.…”

Section: Discussionmentioning

confidence: 99%

Spot urine-guided salt reduction is effective in Japanese cardiology outpatients

Hirota¹,

Sadanaga

Mitamura

et al. 2012

Hypertens Res

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Dietary salt restriction is recommended for the prevention of cardiovascular disease in patients with hypertension and heart failure as well as in the general population. However, salt reduction is very difficult without knowing the daily salt intake of individual patients. A total of 524 subjects (72 ± 10 year old, 246 female) who visited an outpatient cardiology clinic were included in this study. Daily dietary salt intake was estimated based on the sodium and creatinine concentrations of spot urine at the time of enrollment and during follow-up for 8-26 weeks. The attending physicians explained the individual data to the patients and encouraged them to reduce their salt intake through simple counseling. The baseline estimated salt excretion was 9.6 ± 2.7 (range: 3.5-22.1) g per day, which decreased to 8.7 ± 2.3 (3.7-18.0) g per day during follow-up. The systolic blood pressure decreased from 127.0±15.4 (range: 80-170) to 125.6±14.5 (80-172) mm Hg (P ¼ 0.026), and the diastolic blood pressure decreased from 73.4 ± 11.0 (range: 40-106) to 71.5 ± 10.8 (50-102) mm Hg (Po0.001). In conclusion, the estimation of salt intake by spot urine was a useful method for motivating patients to reduce their salt intake; however, achieving salt reduction to the level recommended by the guideline could be a challenge.

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Section: Discussionmentioning

confidence: 99%

Spot urine-guided salt reduction is effective in Japanese cardiology outpatients

Hirota¹,

Sadanaga

Mitamura

et al. 2012

Hypertens Res

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“…26) Studies have indicated that the normal intake of salt can not only maintain the normal operation of the cells and organs of the body in patients with heart failure, but at the same time will also minimize the damage to the internal environment for long-term use of diuretics, and then increase the survival of patients with heart failure and improve their quality of life. 1) The age range of the heart failure patients enrolled in this study was 60 to 89 years old. As age increases, metabolism gradually becomes slower.…”

Section: Discussionmentioning

confidence: 99%

“…1) But so far, the treatment of heart failure is still in the stage of the invention of cardiotonics and diuretics. Diuretics, particularly potent loop diuretics, have long been accepted as the first-line treatment for patients with severe CHF and extreme fluid retention.…”

mentioning

confidence: 99%

Impact of Compound Hypertonic Saline Solution on Decompensated Heart Failure

Yue

Niu

et al. 2017

Int. Heart J.

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SummaryThe aim of the present study was to evaluate the effects of hypertonic saline solution (C-HSS) with high dose furosemide on hospitalization time, readmission, and mortality in patients with New York Heart Association (NYHA) class III heart failure.Decompensated heart failure patients (NYHA III) with chronic ischemic or nonischemic cardiomyopathy and ejection fraction < 40% were divided into 2 groups in an open-label random manner: the first group received a 1-hour intravenous infusion of furosemide (100 mg) plus compound C-HSS (100 mL) twice daily and underwent serious water restriction (500 mL/day); the second group received furosemide intravenous bolus (100 mg) twice a day and water restriction (500 mL/day), without C-HSS. Both groups had normal sodium (120 mmol sodium) intake. After discharge, the two groups continued to receive 120 mmol Na/day and 500-1000 mL water/day.The first group (132 C-HSS patients) had an increase in urination, a reduction in hospitalization time (4 ± 2 versus 7 ± 2 days, P < 0.01), and a reduction in hospitalization costs (2210 RMB versus 3506 RMB, P < 0.01) compared with the second group (132 without C-HSS patients). During the follow-up period (36 ± 12 months), the first group had a significantly higher average readmission time (31.84 ± 7.58 months versus 15.60 ± 6.25 months, P < 0.01) and lower mortality rate (16.5% versus 31.9%, P < 0.01).The results suggest that periodical C-HSS administration, combined with serious water restriction and a normal sodium diet, significantly reduces the hospitalization time, readmission rate, and mortality in patients with NYHA class III HF. (Int Heart J 2017; 58: 601-607)

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“…However, the randomized study [44] comparing low-sodium and normal-sodium diets followed by patients taking high doses of furosemide, revealed that those who limited sodium intake were more often hospitalized. It was associated with changes in the renin-angiotensin-aldosterone (RAA) system, occurring while being on a low-sodium diet.…”

Section: Adherencementioning

confidence: 99%

Czynniki wpływające na rehospitalizacje pacjentów z niewydolnością serca

Szeląg¹,

Kuśnierz

Łoboz-Rudnicka³

et al. 2017

Folia Cardiologica

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Heart failure (HF) is at present an important clinical problem. Hospitalization of HF patients causes that they have a much less favorable prognosis, and their successive rehospitalizations significantly affect the course of the disease and further treatment. The main reason for readmission to hospital is HF exacerbation, which from the pathophysiological point of view is associated with an elevated pressure in the pulmonary circulation. Factors affecting rehospitalization can be divided into: cardiac-related factors such as ischemia, atrial fibrillation, and uncontrolled hypertension, non-cardiac factors including coexisting diseases (especially chronic obstructive pulmonary disease, infections), patient--related factors (nonadherence/noncompliance, self-care, frailty-syndrome, depression, cachexia) and healthcare system-related factors (nonadherence of physicians, therapeutic nihilism, insufficiency of interdisciplinary care system in the field of patients' therapy and education). Rehospitalization of HF patients is a complex, multifactorial and not fully understood problem. An integrated interdisciplinary care system, which covers patients' therapy, education, self--assessment and self-control may reduce the mortality rate and number of rehospitalizations for all reasons and for HF.

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Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?

Cited by 203 publications

References 46 publications

Spot urine-guided salt reduction is effective in Japanese cardiology outpatients

Spot urine-guided salt reduction is effective in Japanese cardiology outpatients

Impact of Compound Hypertonic Saline Solution on Decompensated Heart Failure

Czynniki wpływające na rehospitalizacje pacjentów z niewydolnością serca

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