Is it time to stop recommending strict salt restriction in people with heart failure?

For decades, it's been thought that people with heart failure should drastically reduce their dietary salt intake, but some studies have suggested that salt restriction could be harmful for these patients. A recent review in the European Journal of Clinical Investigation that assessed all relevant studies published between 2000 and 2023 has concluded that there is no proven clinical benefit to this strategy for patients with heart failure.

Most relevant randomized trials were small, and a single large, randomized clinical trial was stopped early due to futility. Although moderate to strict salt restriction was linked with better quality of life and functional status, it did not affect mortality and hospitalization rates among patients with heart failure.

“Doctors often resist making changes to age-old tenets that have no true scientific basis; however, when new good evidence surfaces, we should make an effort to embrace it,” said author Paolo Raggi MD, PhD, of the University of Alberta.

Reference:

Paolo Raggi, Salt versus no salt restriction in heart failure a review, European Journal of Clinical Investigation, https://doi.org/10.1111/eci.14265.