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Background: Despite advancements in diagnosis and management the prevalence of heart failure is increasing (Al-Mohammad 2011). A recent epidemiological analysis found that in 2010 more than 41 million people were living with heart failure globally (Forouzanfar 2013). The majority of heart failure cases were attributable to ischaemic heart disease (Forouzanfar 2013; Mosterd 2007). UK estimates suggest that 13% of males and 12% of females aged over 75 years have heart failure (BHF 2012). The increasing burden of disease management is predicted to affect both primary and secondary care, with the majority of costs being attributable to the hospitalization of individuals with heart failure (Stewart 2002; Stewart 2003). While pharmacological management is widely accepted as the mainstay of treatment, several international guidelines emphasize the importance of lifestyle changes as an adjunct to pharmaceutical therapies (BHF 2012; Canada 2012; Dickstein 2008; SIGN 2007; HFSA 2010). For example, the UK National Institute for Health and Care Excellence (NICE) advises beneficial changes relating to diet, physical activity, weight loss, smoking, alcohol consumption and annual vaccinations (NICE 2010). Several guidelines worldwide also advocate the importance of dietary advice in individuals with heart failure, specifically advice to reduce sodium intake both in the hospital and community (outpatient) setting (Gupta 2012). The rationale for such advice is described below.

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Wiley Online Library

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Issue 7