Abstract 3804: A High Sodium Diet is Associated With Acute Decompensated Heart Failure Hospitalization in Free-living Heart Failure Patients
A low sodium diet (≤2 g/day) is the primary nutritional recommendation for patients with heart failure (HF). However, there is minimal clinical and epidemiologic evidence evaluating this guideline. We prospectively studied the relationship between habitual sodium intake and all-cause hospitalization and acute decompensated HF (ADHF) hospitalization in outpatients with HF. We included 123 HF patients (60±13 years, LVEF 25±9%) enrolled between 2003 and 2007 from two outpatient HF clinics. Dietary sodium and other nutrient intake estimates were obtained by two 3-day food records. Events were adjudicated from medical records by a cardiologist blinded to dietary intake. Patients were divided into tertiles based on sodium intake. Cox proportional hazards regression was used to estimate hazard ratios (HR) and Kaplan-Meier curves with log-rank tests to compare survival curves. Mean follow-up time was 3.5 years (range, 0.9 to 5.0 years). Mean sodium intake was 1.4±0.3 g, 2.4±0.3 g, and 3.8±0.6 g per day in the lowest (n=41), middle (n=41) and highest tertile (n=41), respectively. At 5 years, patients in the highest tertile of sodium intake had a lower event-free rate for ADHF of 55.8±11.4% compared to 73.3±6.8% for patients in the lowest tertiles (p=0.006, Figure⇓). When adjusted for age and sex the HR for ADHF was 3.8 (95% CI, 1.6 –9.0, p=0.003) and the HR for all-cause hospitalization was 1.8 (95% CI, 1.0 –3.3, p=0.069) for. This is the first evidence that stable HF patients who consume high amounts of sodium are at greater risk for early ADHF hospitalization compared to patients consuming lower levels of dietary sodium.