PMID- 30398532
OWN - NLM
STAT- MEDLINE
DCOM- 20190913
LR  - 20210109
IS  - 2168-6114 (Electronic)
IS  - 2168-6106 (Linking)
VI  - 178
IP  - 12
DP  - 2018 Dec 1
TI  - Reduced Salt Intake for Heart Failure: A Systematic Review.
PG  - 1693-1700
LID - 10.1001/jamainternmed.2018.4673 [doi]
AB  - IMPORTANCE: Recent estimates suggest that more than 26 million people worldwide 
      have heart failure. The syndrome is associated with major symptoms, significantly 
      increased mortality, and extensive use of health care. Evidence-based treatments 
      influence all these outcomes in a proportion of patients with heart failure. 
      Current management also often includes advice to reduce dietary salt intake, 
      although the benefits are uncertain. OBJECTIVE: To systematically review 
      randomized clinical trials of reduced dietary salt in adult inpatients or 
      outpatients with heart failure. EVIDENCE REVIEW: Several bibliographic databases 
      were systematically searched, including the Cochrane Central Register of 
      Controlled Trials, MEDLINE, Embase, and CINAHL. The methodologic quality of the 
      studies was evaluated, and data associated with primary outcomes of interest 
      (cardiovascular-associated mortality, all-cause mortality, and adverse events, 
      such as stroke and myocardial infarction) and secondary outcomes 
      (hospitalization, length of inpatient stay, change in New York Heart Association 
      [NYHA] functional class, adherence to dietary low-salt intake, and changes in 
      blood pressure) were extracted. FINDINGS: Of 2655 retrieved references, 9 studies 
      involving 479 unique participants were included in the analysis. None of the 
      studies included more than 100 participants. The risks of bias in the 9 studies 
      were variable. None of the included studies provided sufficient data on the 
      primary outcomes of interest. For the secondary outcomes of interest, 2 
      outpatient-based studies reported that NYHA functional class was not improved by 
      restriction of salt intake, whereas 2 studies reported significant improvements 
      in NYHA functional class. CONCLUSIONS AND RELEVANCE: Limited evidence of clinical 
      improvement was available among outpatients who reduced dietary salt intake, and 
      evidence was inconclusive for inpatients. Overall, a paucity of robust 
      high-quality evidence to support or refute current guidance was available. This 
      review suggests that well-designed, adequately powered studies are needed to 
      reduce uncertainty about the use of this intervention. PROTOCOL REGISTRATION: 
      PROSPERO Identifier: CRD42015019504.
FAU - Mahtani, Kamal R
AU  - Mahtani KR
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
FAU - Heneghan, Carl
AU  - Heneghan C
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
FAU - Onakpoya, Igho
AU  - Onakpoya I
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
FAU - Tierney, Stephanie
AU  - Tierney S
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
FAU - Aronson, Jeffrey K
AU  - Aronson JK
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
FAU - Roberts, Nia
AU  - Roberts N
AD  - Knowledge Centre, Bodleian Libraries, Old Road Campus, University of Oxford, 
      Oxford, United Kingdom.
FAU - Hobbs, F D Richard
AU  - Hobbs FDR
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
FAU - Nunan, David
AU  - Nunan D
AD  - Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health 
      Sciences, University of Oxford, Oxford, United Kingdom.
LA  - eng
GR  - IS-SPC-0514-10043/DH_/Department of Health/United Kingdom
GR  - MC_PC_11004/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
PL  - United States
TA  - JAMA Intern Med
JT  - JAMA internal medicine
JID - 101589534
RN  - 0 (Sodium Chloride, Dietary)
SB  - IM
CIN - JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PMID: 30398519
CIN - JAMA Intern Med. 2019 Jul 1;179(7):1006-1007. PMID: 31260009
MH  - *Diet, Sodium-Restricted
MH  - Heart Failure/*diet therapy
MH  - Humans
MH  - Sodium Chloride, Dietary
EDAT- 2018/11/07 06:00
MHDA- 2019/09/14 06:00
CRDT- 2018/11/07 06:00
PHST- 2018/11/07 06:00 [pubmed]
PHST- 2019/09/14 06:00 [medline]
PHST- 2018/11/07 06:00 [entrez]
AID - 2712563 [pii]
AID - 10.1001/jamainternmed.2018.4673 [doi]
PST - ppublish
SO  - JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. doi: 
      10.1001/jamainternmed.2018.4673.