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Sodium Restriction in Heart Failure: Benefit or Harm?

  • Heart Failure (W Tang, Section Editor)
  • Published:
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Opinion statement

Current guidelines vary in the recommended amount of dietary sodium intake for heart failure (HF) patients. Observational studies and the hypertension literature support the concept that sodium restriction improves HF outcomes. In contrast, several randomized controlled trials imply that dietary sodium restriction can cause harm through hypovolemia and increased neurohormonal activation. Data from hypertensive animal models and humans suggest that dietary sodium intake may need to be individually tailored based on HF severity and the physiologic response to sodium loading. Future studies must assess interactions between sodium intake, fluid intake, and diuretics to match clinical practice and improve safety. More information is needed in multiple areas, including accurate measurement of sodium intake, implementation of dietary changes in HF patients, and establishment of biomarkers that predict response to changes in sodium intake. Additional research is urgently needed to determine the true impact of the most commonly recommended self-care strategy in HF.

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Conflict of Interest

Dr. Scott L. Hummel received a grant from NIH/NHLBI (#K23HL109176).

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA

    Matthew C. Konerman MD & Scott L. Hummel MD, MS

  2. Division of Cardiology, Ann Arbor Veterans Affairs Health System, Ann Arbor, MI, USA

    Scott L. Hummel MD, MS

  3. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Frankel Cardiovascular Center, 1500 E. Medical Center Dr., SPC 5853, Ann Arbor, MI, 48109-5853, USA

    Scott L. Hummel MD, MS

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Correspondence to Scott L. Hummel MD, MS.

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Konerman, M.C., Hummel, S.L. Sodium Restriction in Heart Failure: Benefit or Harm?. Curr Treat Options Cardio Med 16, 286 (2014). https://doi.org/10.1007/s11936-013-0286-x

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