April 1, 2024Open Access
View Full PaperDietary Sodium and Fluid Intake in Heart Failure. A Clinical Consensus Statement of the Heart Failure Association of the ESC
Key Result
Current guidelines advise limiting sodium intake to no more than 5 g/day in heart failure patients and fluid restriction only for selected cases.
Structured PICO
Does dietary sodium and fluid restriction improve outcomes in patients with acute and chronic heart failure?
P
Population
Patients with acute and chronic heart failure
I
Intervention
Dietary sodium and fluid restriction
This clinical consensus statement highlights that strict dietary sodium and fluid restrictions in heart failure lack robust evidence, are poorly adhered to, and may cause harm, supporting a more lenient approach.
Main Result
Absolute Event Rate: 0% vs 0%
Abstract
Abstract Sodium and fluid restriction has traditionally been advocated in patients with heart failure (HF) due to their sodium and water avid state. However, most evidence regarding the altered sodium handling, fluid homeostasis and congestion-related signs and symptoms in patients with HF originates from untreated patient cohorts and physiological investigations. Recent data challenge the beneficial role of dietary sodium and fluid restriction in HF. Consequently, the European Society of Cardiology HF guidelines have gradually downgraded these recommendations over time, now advising for the limitation of salt intake to no more than 5 g/day in patients with HF, while contemplating fluid restriction of 1.5–2 L/day only in selected patients. Therefore, the objective of this clinical consensus statement is to provide advice on fluid and sodium intake in patients with acute and chronic HF, based on contemporary evidence and expert opinion.