Three Gram Sodium Intake is Associated With Longer Event-Free Survival Only in Patients With Advanced Heart Failure

Lennie, Terry A.; Song, Eun Kyeung; Wu, Jia Rong; Chung, Misook L.; Dunbar, Sandra B.; Pressler, Susan J.; Moser, Debra K.

doi:10.1016/j.cardfail.2010.11.008

Cited by 115 publications

(110 citation statements)

References 23 publications

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“…20, 45 Arcand and colleagues 45 showed that in a HF cohort consisting mostly of patients with NYHA class I to II symptoms, Ն2800 mg/d sodium resulted in more HF hospitalizations in comparison with those on lower intake. Lennie and colleagues 20 interestingly showed Ͻ3000 mg/d sodium was associated with better outcomes in NYHA class III to IV patients, whereas it was associated with significant increase in hospital visits, readmissions, and mortality in NYHA class I to II patients.…”

Section: Discussionmentioning

confidence: 99%

“…18 Congruent with this observation, a recent study reported that only 34% of patients consume Ͻ3000 mg and only 15% consume Ͻ2000 mg sodium daily based on their 24-hour urinary sodium excretion. 20 Sodium consumption Ͻ2000 mg/d is difficult to achieve even with dietician education, 21 and studies have demonstrated that sex 22 and race 23 affect dietary preferences and adherence to sodium restriction recommendations in patients with HF.…”

Section: Sodium Intake Recommendations and Patternsmentioning

confidence: 99%

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Dietary Sodium Intake in Heart Failure

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Section: Sodium Intake Recommendations and Patternsmentioning

confidence: 99%

Dietary Sodium Intake in Heart Failure

et al. 2012

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“…With patient or family assistance, hospital discharge and other medical records were obtained from identified sources of care outside of the study‐site healthcare systems. We have >20 years of experience collecting these data and have successfully obtained hospitalization data on all rural patients in our current and previous studies 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41. All‐cause mortality data (date and cause of death) were collected for 1 year from baseline by a combination of medical record review, electronic clinical record review, interviews with patients’ healthcare providers and family, and public death record review 30, 31, 40, 41, 42, 43…”

Section: Methodsmentioning

confidence: 99%

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Lennie

Andreae

Rayens

et al. 2018

JAHA

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BackgroundDietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death.Methods and ResultsFour‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems for Research. Micronutrient deficiencies were determined according to methods recommended by the Institute of Medicine. Patients were followed for 1 year to collect data on all‐cause hospitalization or death. Patients were divided according to number of dietary micronutrient deficiencies at a cut point of ≥7 for the high deficiency category versus <7 for the no to moderate deficiency category. In the full sample, 29.8% of patients experienced hospitalization or death during the year, including 44.3% in the high‐deficiency group and 25.1% in the no/moderate group. The difference in survival distribution was significant (log rank, P=0.0065). In a Cox regression, micronutrient deficiency category predicted time to event with depression, NYHA classification, comorbidity burden, body mass index, calorie and sodium intake, and prescribed angiotensin‐converting enzyme inhibitors, diuretics, or β‐blockers included as covariates.ConclusionsThis study provides additional convincing evidence that diet quality of patients with heart failure plays an important role in heart failure outcomes.

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“…When quality assurance information related to urine collection was provided, it was often quite limited. Only 5 of the 9 included studies reported quality assurance procedures or excluded participants on the basis of incomplete collections, 47,54,57,60,66 and 1 excluded incomplete collections in a sensitivity analysis. 69 Exclusions in these studies ranged from <1% to 11% compared with the 20% to 25% reported in studies that used PABA (p-aminobenzoic acid) testing 28 (onlineonly Data Supplement Table 2a).…”

Section: Menmentioning

confidence: 99%

Methodological Issues in Cohort Studies That Relate Sodium Intake to Cardiovascular Disease Outcomes

Cobb¹,

Anderson²,

Elliott³

et al. 2014

Circulation

253

243

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Background-The results of cohort studies relating sodium (Na) intake to blood pressure-related cardiovascular disease (CVD) are inconsistent. To understand whether methodological issues account for the inconsistency, we reviewed the quality of these studies. Methods and Results-We reviewed cohort studies that examined the association between Na and CVD. We then identified methodological issues with greatest potential to alter the direction of association (reverse causality, systematic error in Na assessment), some potential to alter the direction of association (residual confounding, inadequate follow-up), and the potential to yield false null results (random error in Na assessment, insufficient power). We included 26 studies with 31 independent analyses. Of these, 13 found direct associations between Na and CVD, 8 found inverse associations, 2 found J-shaped associations, and 8 found null associations only. On average there were 3 to 4 methodological issues per study. Issues with greater potential to alter the direction of association were present in all but 1 of the 26 studies (systematic error, 22; reverse causality, 16). Issues with lesser potential to alter the direction of association were present in 18 studies, whereas those with potential to yield false null results were present in 23. Conclusions-Methodological issues may account for the inconsistent findings in currently available observational studies relating Na to CVD. Until well-designed cohort studies in the general population are available, it remains appropriate to base Na guidelines on the robust body of evidence linking Na with elevated blood pressure and the few existing general population trials of the effects of Na reduction on CVD. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 26, 2013. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The American Heart Association requests that this document be cited as follows: Cobb LK, Anderson CAM, Elliott P, Hu FB, Liu K, Neaton JD, Whelton PK, Woodward M, Appel LJ; on behalf of the American Heart Association Council on Lifestyle and Metabolic Health. Methodological issues in cohort studies that relate sodium intake to cardiovascular disease outcomes: a science advisory from the American Heart Association.

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Three Gram Sodium Intake is Associated With Longer Event-Free Survival Only in Patients With Advanced Heart Failure

Cited by 115 publications

References 23 publications

Dietary Sodium Intake in Heart Failure

Dietary Sodium Intake in Heart Failure

Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure

Methodological Issues in Cohort Studies That Relate Sodium Intake to Cardiovascular Disease Outcomes

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