In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Pass the salt please!

A comment by Patrick Doherty, EACPR Cardiac Rehabilitation Section


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.

Should we put the salt shaker down?
Clinical Seminar - ESC Congress 2012, Munich
View Slides