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J Card Fail. 2015 Apr;21(4):323-9. doi: 10.1016/j.cardfail.2014.12.016. Epub 2015 Jan 7.

Dietary sodium adherence is poor in chronic heart failure patients.

Author information

1
OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital, Columbus, Ohio. Electronic address: anupambasuray@gmail.com.
2
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
3
Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio; Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio.
4
Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio.
5
Department of Psychology, Kent State University, Kent, Ohio.
6
Summa Health System, Akron City Hospital, Akron, Ohio.
7
Division of Cardiology, Department of Internal Medicine, University Hospital, Salt Lake City, Utah.

Abstract

BACKGROUND:

We sought to determine the rates and predictors of dietary sodium restriction and to evaluate the reliability of 24-hour urine collection as a tool to estimate dietary sodium intake in heart failure (HF) patients.

METHODS AND RESULTS:

We evaluated the 24-hour urinary sodium excretion of 305 outpatients with HF and reduced ejection fraction who were educated on following a <2 g sodium diet. The mean sodium excretion according to a single sample from each participant was 3.15 ± 1.58 g, and 23% were adherent to the <2 g recommendation. One hundred sixty-eight participants provided 2 samples with urinary creatinine excretion within normative range. Averaging both resulted in a mean sodium excretion of 3.21 ± 1.20 g and lower adherence rates to the <2-gram diet: 14% versus 23% (P = .019). Multivariate logistic regression showed only male sex and higher body mass index (BMI) to be associated with nonadherence (male: odds ratio [OR] 2.20, 95% confidence interval [CI] 1.25-3.88; 1 unit BMI: OR 1.05, 95% CI 1.01-1.10). Bland-Altman plots of urinary sodium and creatinine showed poor reproducibility between samples.

CONCLUSIONS:

In this chronic HF population, sodium consumption probably exceeds recommended amounts, particularly in men and those with higher BMI. Urine analyses were not highly reproducible, suggesting variation in both diet and urine collection.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01461629.

KEYWORDS:

Sodium; compliance; diet; salt

PMID:
25576680
PMCID:
PMC4395528
DOI:
10.1016/j.cardfail.2014.12.016
[Indexed for MEDLINE]
Free PMC Article

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