The Association of Sodium Intake and Objective and Subjective Indicators of Heart Failure Severity

Sodium (Na) restriction is a hallmark of heart failure (HF) care, but its effectiveness is unproven. We sought to assess the relationship between Na intake and HF symptoms and severity. 93 patients (73 males; mean=57 ± 12 years) with HF (EF≤40; mean EF=23 ± 7%) completed the Dietary Compliance Survey, detailing consumption of high Na foods within the previous 3 days. Individuals were divided into 2 categories for comparative analyses - patients who reported consumption of 0 to 5 high-Na content foods (Lo Na) and those who reported consumption of six or more high-Na content foods (Hi Na). HF symptoms were assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ), and two HF biomarkers, b-type natriuretic peptide (BNP) and C-reactive protein (CRP). Both BNP and CRP data were log transformed. Psychological factors, including stress and depressive symptoms, were examined as possible correlates of dietary compliance, using the Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI), respectively. Individuals reported consuming an average of 6 ± 4 salty foods in the 3 days prior to assessment. CRP concentrations were significantly higher in the Lo Na group than in the Hi Na group (see Table). In examining KCCQ self-reported symptoms, individuals in the Hi Na group reported significantly fewer symptoms on multiple subscales. PSS scores did not differ between the two groups. However, subjects in the Lo Na group reported significantly more depressive symptoms than those in the Hi Na group.Tabled 1Comparison of Means Between Na Intake GroupsGroupNumber of Foods Consumedlog CRPlog BNPKCCQ Symptom FrequencyKCCQ Total SymptomKCCQ Overall SummaryBDILo Na (n=58)3 ± 20.66 ± 0.492.42 ± 0.5167 ± 2868 ± 2767 ± 2314 ± 10Hi Na (n=35)10 ± 4∗0.42 ± 0.44∗2.32 ± 0.5376 ± 19∗78 ± 17∗77 ± 16∗10 ± 8∗∗=p