Severely reduced salt intake can have fatal consequences in heart failure - healing practice

Link between salt intake and heart failure

Limiting salt intake is considered an important part of treating hypertension and heart failure. However, overrestriction can have a variety of serious adverse effects for people with heart failure.

A new study involving experts from Sun Yat-sen University (China) has examined the link between salt restriction and the risk of clinical outcomes in people with heart failure. The results can be read in the specialist journal "Heart".

Data from 1,713 people were assessed

To determine a possible link between salt intake and heart failure, the team carried out a secondary analysis of data from 1,713 people aged 50 and over who had what was called heart failure with fraction d preserved ejection.

Participants' salt intake

All participants were asked about their current use of salt in the preparation of staple foods. Salt intake was rated on a scale of zero to three. 0 points meant none, one stood for an eighth of a teaspoon, two stood for a quarter of a teaspoon, and three stood for half a teaspoon or more of salt, the researchers explain.

The state of health of the participants was medically monitored over an average period of three years.

Guidelines advise limiting salt intake

Researchers report that guidelines for heart failure often recommend limiting salt intake. However, the optimal range for the restriction and particularly the effect in heart failure with preserved ejection fraction is unclear.

What is heart failure with preserved ejection fraction?

Heart failure with preserved ejection fraction is a common form of heart failure and accounts for about half of all heart failure cases, according to the team. It occurs when the lower left chamber of the heart (left ventricle) is unable to fill properly with blood (diastolic phase).

About half of the participants (816) reported a salt level of zero when preparing meals. More than half of these people were men (56%). It found that these people weighed significantly more and had lower diastolic blood pressure (70 mm Hg) than participants with a salt concentration above zero (897), the team said.

More hospitalizations for lack of salt?

However, people with zero salt were more likely to be hospitalized for heart failure and had type 2 diabetes. They also often had poorer kidney function.

Protection against premature cardiovascular death thanks to more salt

When participants had a salt level above zero, it was associated with a significantly lower risk of cardiovascular death and hospitalization for heart failure than participants with a score of zero, the experts report in a press release.

However, people with a salt level above zero did not have a lower overall risk of premature death than participants with a salt level of zero.

What role does age play in salt intake?

According to the researchers, participants under the age of 70 benefited significantly more from the addition of table salt than those over the age of 70 when it came to the risk of cardiovascular death or hospitalization for heart failure.

Additionally, black people and people from other ethnic groups appear to benefit more from adding salt to their meals than people from white ethnic groups, although the differences were small, the team found.

Low sodium intake beneficial for blood pressure

Minimizing sodium intake is associated with lower blood pressure and reduced risk of cardiovascular disease in the general population and in people with high blood pressure.

However, according to the team, too severe a restriction of salt intake could be harmful in heart failure with preserved ejection fraction and would be associated with a poorer prognosis of the disease. (as)

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This text corresponds to the specifications of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.


Jiayong Li, Zhe Zhen, Peisen Huang, Yu-Gang Dong, Chen Liu, et al. : salt restriction and risk of adverse effects in heart failure with preserved ejection fraction; in: Heart (published 6/18/2022), HeartBMJ: Too restrictive salt intake may worsen outcomes of common form of heart failure, BMJ

Important Note:
This article contains general advice only and should not be used for self-diagnosis or treatment. It cannot substitute a visit to the doctor.