Abstract 17266: Impact of Dietary Salt Intake on Heart Failure Related Hospitalizations in Patients with Preexisting Heart Failure: a Sub study of the HART Trial (NCT00018005)
Background: Salt restriction is advised in patients with heart failure (HF). Data on salt restriction and outcomes in HF are inconsistent. Emerging data suggest that strict dietary salt restriction in HF is associated with poorer outcomes. We sought to assess the impact of dietary salt intake on HF hospitalizations.
Methods: We analyzed data from HART (Heart failure Adherence and Retention Trial) which enrolled NYHA class II/III patients with HF. Patients were divided into 3 groups based on their daily salt intake as assessed by a validated food frequency questionnaire; restricted (<2500 mg), moderate (2500- 4000 mg) and liberal (>4000 mg). Univariate cox regression models were used to determine univariate predictors of HF hospitalizations. Multivariate Cox regression model was fit to determine the impact of salt intake on HF hospitalization, adjusted for significant univariate predictors of outcome.
Results: HART enrolled 902 patients. Data on salt intake was available on 761 patients; restrictive, moderate and liberal groups had 151, 367 and 243 patients, respectively; median follow up was 30 months. Comparing restricted vs. moderate vs. liberal salt intake groups, the restricted group was dominated by women (56% vs 50% vs 38%) and Caucasians (65% vs 68% vs 55%), covered least distance on 6 minute walk test (716 m vs 851 m vs 887 m), and were more likely to be on β-blockers (80% vs 73% vs 66%); all P valves <0.05. Compared to restrictive group, multivariate Cox regression analysis showed no difference in the risk of HF hospitalizations between all three salt intake groups (Fig. 1).
Conclusions: Salt restriction does not seem to significantly impact HF hospitalization after correcting for covariates. Reverse causality bias (sicker patients were most salt restricted) is a plausible explanation of these findings. Thus, randomized controlled trials to determine safe and effective salt intake target range are needed.
Author Disclosures: A. Mangla: None. R. Doukky: None. E. Segawa: None. E. Avery: None. D. Richardson: None. L.H. Powell: None.
- © 2014 by American Heart Association, Inc.