Normal sodium diet versus low sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?

Salvatore Paterna , Gaspare Parrinello , Sergio Fasullo , Filippo M Sarullo , Pietro Di Pasquale (1)

1 Cardiology

The study evaluated the effects of a normal (120 mmol Na) versus a low sodium diet (80 mmol Na) on readmissions for HF during six months of follow-up in compensated congestive heart failure (CHF) patients. 232 (88 F/144 M) compensated CHF pts (from IV to II Class NYHA) aged 55 to 83 years, with EF <35% and serum creatinine <2 mg/dl were randomized in 2 groups: group 1: 118 pts (45 F/73 M) received a normal sodium diet plus oral furosemide (250-500 mg bid); Group 2: 114 pts (43 F/71 M): received a low sodium diet plus oral furosemide (250-500 mg bid),and the treatment received after discharge (30 days) and for 180-days after, associated with a drink intake of 1000 ml daily. Signs of CHF, BW,BP,HR, laboratory parameters, ECG, echocardiogram, BNP;Aldosterone values and plasma renin activity (PRA) were examined at baseline, and 180 days after. Normal sodium group showed a significant reduction (p<0.05) in readmissions. BNP values were lower in normal sodium group (685±255 pg/ml vs 425±125 pg/ml; p<0.0001) than low sodium group. The aldosterone and PRA showed significant increase (p<0.0001) in low sodium group during follow up, while normal sodium showed a little significant reduction (p=0.039) in aldosterone levels and not significant difference in PRA levels. After 6 months of follow up, aldosterone and PRA were (p<0.0001) significantly higher in low sodium group. Normal sodium group showed a lower incidence of re-hospitalization during the follow up and a significant reduction in BNP, aldosterone plasma levels and PRA. Our date show that a normal sodium diet improves outcome and sodium depletion has detrimental renal and neurohormonal effects with worse clinical outcome in compensated HF patients. Further studies are required to determine if this is due to high dose diuretic or low-sodium diet.

Mots clés: Medicine

Salvatore Paterna, Gaspare Parrinello, Sergio Fasullo, Filippo M Sarullo, Pietro Di Pasquale. Normal sodium diet versus low sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?. Clinical Science, 2007, 114 (3), pp.221-230. ⟨10.1042/CS20070193⟩. ⟨hal-00479386⟩