Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Researchers at the University of Oxford have found limited evidence of any benefit for heart failure patients who follow a low-salt diet, despite many international guidelines recommending this.

The review, funded by the NIHR School for Primary Care Research, included just nine small trials, involving a total of 479 participants. None of these studies provided clinically relevant data to determine whether a low-salt diet is associated with a reduced risk of death from heart attack or stroke, hospitalisation or length of hospital stay. However, for patients not in hospital, the authors found no significant evidence of harms from a reduction of dietary salt intake and a trend for some clinical improvements.

Lead author, Dr Kamal Mahtani, an Oxfordshire GP and Associate Professor in the Nuffield Department of Primary Care Health Sciences, said: “ A lot of the guidelines appear to vary in the exact advice they give heart failure patients when it comes to reducing salt intake. Our research highlights a lack of robust, high-quality evidence available to support or refute current guidance.

"When considering a lower salt diet, patients with heart failure should discuss the evidence with their healthcare professional, and come to a shared decision based on both the evidence and the individual circumstances of the patient." 

Writing in JAMA Internal Medicine, the research team suggest larger, well-designed studies are needed and recommend that clinicians and policymakers should acknowledge the weak evidence base for heart failure patients when considering a salt-restricted diet.

Full press release from University of Oxford.

Publications

Reduced Salt Intake for Heart Failure. A Systematic Review.
Kamal R Mahtani, Carl Heneghan, Igho Onakpoya, Stephanie Tierney, Jeffrey K Aronson, Nia Roberts, F.D Richard Hobbs, David Nunan
JAMA Internal Medicine 2018 doi: 10.1001/jamainternmed.2018.4673

Sodium Restriction in Heart Failure: Too Much Uncertainty—Do the Trials.
Yancy CW. 
JAMA Internal Medicine. 2018. doi:10.1001/jamainternmed.2018.4653