Abstract 18888: Less Than 2g of Dietary Sodium Intake is Associated with Shorter Event-free Survival in Patients with Compensated Heart Failure
Background: Dietary sodium restriction is a standard component of heart failure (HF) management. There is a growing concern that aggressive sodium restriction is not warranted in compensated HF patients on stable medication therapy. Purpose. The purpose of this study was to compare differences in event-free survival (all-cause hospitalization or death) among patients with a dietary sodium intake above and below 2g; the lowest recommended level in current guidelines.
Method: A total of 244 patients with HF (66% male, 61±12 years, 45% NYHA class III/IV, ejection fraction [EF] 34±13%) completed a detailed 4-day food diary to measure average daily caloric and sodium intake. Event-free survival for median 365 follow-up days and covariate data on age, gender, etiology, body mass index, NYHA class, EF, total comorbidity score, and prescribed medication was determined by patient interview and medical record review. Hierarchical Cox hazard regression was used to compare differences in event-free survival between patients with < 2g, 2 to 3g, or > 3g of daily sodium intake stratified by NYHA class (NYHA class I/II vs. III/IV).
Results: Patients in NYHA class I/II with < 2g/day of sodium intake had shorter event-free survival compared to both groups in NYHA class I/II with higher sodium intake (p = .024). There was no significant difference in event-free survival between patients with 2 to 3g vs. > 3g of daily sodium intake (p = .149) in NYHA class I/II. Less than 2g of sodium intake per day was independently associated with higher risk for hospitalization or death (hazard ratio = 4.3, 95% CI = 1.2-15.4) after controlling for covariates and caloric intake. In contrast, no level of sodium intake was a predictor of event-free survival of patients in NYHA class III/IV.
Conclusion: These findings provide relevant evidence based on actual sodium intake to support the concern that aggressive sodium restriction may not be warranted in well compensated HF patients.
- © 2010 by American Heart Association, Inc.