Least sodium in food isn’t always best for heart health

Applying a stringent salt intake restriction does not appear to be beneficial to patients with heart failure with preserved ejection fraction (HFpEF), with a recent study showing that such an approach rather worsens the prognosis of these patients.

The study examined the effect of salt restriction in cooking on the risks of clinical outcomes in patients with HFpEF. Researchers looked at 1,713 participants from the Americas in the TOPCAT trial. They calculated cooking salt score as the sum of self-reported salt added during homemade food preparation.

The primary endpoint of the risk of the composite of cardiovascular death, HF hospitalization, and aborted cardiac arrest was significantly lower among patients with cooking salt score >0 than among those with cooking salt score 0 (hazard ratio [HR], 0.760, 95 percent confidence interval [CI], 0.638–0.906; p=0.002). The risk of HF hospitalization was also lower in the cooking salt score >0 group (HR, 0.737, 95 percent CI, 0.603–0.900; p=0.003).

Meanwhile, there was no significant difference noted in the risks of all-cause (HR, 0.838, 95 percent CI, 0.684–1.027; p=0.088) and cardiovascular death (HR, 0.782, 95 percent CI, 0.598–1.020; p=0.071).

In sensitivity analyses that used propensity score matching and included patients who prepared meals mostly at home, results were consistent. However, the association between stringent salt restriction and poor HFpEF outcomes was more pronounced among patients aged ≤70 years and those of non-White race.