[Is the low-sodium diet actually indicated for all patients with stable heart failure?].
BACKGROUND
Although a low-sodium diet is indicated for heart failure HF, there is no evidence this dietary restriction is beneficial to all patients.


OBJECTIVE
To prospectively study the acute effectsof a low-sodium diet in patients (pts) with heart failure (HF).


METHODS
Fifty stable outpatients with mild to moderate HF who reported previously consuming 6.6 g table salt/day were studied. In Phase 1, all pts were submitted to a diet with 2 g of salt during 7 days, followed by randomization in 2 subgroups (Phase 2): one to receive 6 g of salt (subgroup 1) and the other, 2 g of salt/day for 7 days (subgroup II).


RESULTS
Phase 1: the diet with 2 g of salt reduced the BMI, plasma and urinary sodium, protein consumption, iron, zinc, selenium and vitamin B12; it increased plasma levels of norepinephrine, nitrate, serum aldosterone and improved quality of life. Phase 2: for pts with low BMI, the use of 6 g salt/day acutely decreased the levels of norepinephrine, albumin and cholesterol in plasma. No difference was observed in pts with higher BMI.


CONCLUSIONS
The diet with 2 g salt/day for pts with HF increased the neurohormonal activation associated to HF progression. The BMI can influence the response to the neurohormonal activation in a low-sodium diet in pts with HF. Further studies to test salt restriction for longer periods are recommended.
Nakasato
Miyoko
M
Instituto do Coração, Faculdade de Medicin, Universidade de São Paulo, SP, Brasil. miyoko@cardiol.br
Strunk
Célia M C
CM
Guimarães
Guilherme
G
Rezende
Marcos V C
MV
Bocchi
Edimar A
EA
D015992:Body Mass Index; D004039:Diet, Sodium-Restricted / Q000009:adverse effects*; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000178:diet therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012982:Sodium, Dietary / Q000008:administration & dosage*
D012982:Sodium, Dietary