Abstract 12196: Self-reported Adherence to a Low Sodium Diet Independently Predicts Cardiac Event-free Survival in Patients with Heart Failure

Abstract

Background. A low sodium diet (LSD) is a standard component of self-care for better health outcomes in heart failure (HF) patients. Clinicians rely on patients’ self-report of following an LSD to determine adherence, but the impact of self-reported adherence to an LSD on cardiac event-free survival is unknown. Purposes. To determine 1) whether self-reported adherence is concordant with objectively measured adherence to an LSD and 2) whether self-reported adherence to an LSD independently predicts cardiac event-free survival. Methods. A total of 119 patients with HF (30% female, 65±9 years, 45% NYHA III/IV) provided a 24-hour urine sodium to estimate daily sodium intake. Patients were asked to rate “how often do you eat an LSD?” on a scale from 1 (never or rarely) to 4 (always) using one item from the Self-Care of HF Index scale. Patients were followed for 1-year to determine cardiac events (i.e., cardiac-related hospitalization or emergency department visit) through patient interview and medical record review. One-way ANOVA was used to determine the concordance of self-reported adherence with objectively measured adherence to an LSD. Hierarchical Cox hazard regression was used to compare differences in cardiac event-free survival among 4 groups with different levels of self-reported adherence to an LSD.

Results. Thirty-one patients (26%) reported that they always ate an LSD and had an average sodium intake < 3g/day (F = 3.393, p = .020). Forty-five patients had cardiac events during the 1-year follow-up. Patients who reported they never or rarely follow an LSD had 4.7 times higher risk for shorter cardiac event-free survival (p = .017) compared to those who always ate an LSD in hierarchical Cox hazard regression (Figure).

Conclusion. This finding provides evidence that patients who always follow an LSD have better health outcomes. It is recommended that a rating scale on self-report of adherence to an LSD can be used clinically to identify patients at risk for high sodium intake.