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Dr. Patrick Doherty,
A recent paper by DiNicolantonio et al in Heart (2012) entitled "Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis"raises serious questions about the advice given to patients with heart failure in respect of restricted salt diets. This publication parallels one of the clinical seminar sessions presented at the ESC Congress in Munich where the evidence for restricted salt diets was debated by the panel and delegates. As with many treatments it’s hardly surprising that no single recommendation fits the variation seen in patients but these publications suggest that our advice "low salt is best" may be causing "more harm than good" in certain patients with cardiovascular disease. Research in this area is not without its challenges as the interaction between diet, medication (e.g. diuretics) and path-physiological processes, at this time, prevents researchers from identifying underpinning mechanisms and making clear recommendations. The topic of salt intake cuts across classic cardiovascular subject areas which means a collaborative effort is urgently needed to resolve this issue and give clear guidance to clinicians and patients.
DiNicolantonio JJ, Pasquale PD, Taylor RS, et al in Heart (2012). Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis. doi:10.1136/heartjnl-2012-302337 Abstract Should we put the salt shaker down? Clinical Seminar - ESC Congress 2012, Munich View Slides