Reducing salt intake is practically universal advice when most of the Western world, including Spain, tends to be more guilty of excess than of defects in its consumption. It is known that controlling the sodium that we incorporate into the body is essential to improve pathologies such as heart failure and reduce the cardiovascular risk. However, you don’t have to go overboard.
That is the conclusion reached by a recent study published in the journal Heart: some patients who suffer heart failure Y reduce salt intake too much they can worsen more if his illness fits.
Currently, it is usually recommended to reduce salt intake in heart failure as such, but the optimal range of your restriction (between 1.5 g and 3 g daily) and its effects on some patients is unclear: many patients have been excluded from large studies with relevant results.
[El popular ingrediente en España que te está matando sin que te des cuenta]
This is the case of patients diagnosed with heart failure with preserved ejection fraction, which account for half of all cases of heart failure worldwide. In these cases, what happens is that the left ventricle of the heart does not fill properly, which reduces the amount of blood that it pumps to the body.
To better understand this type of patient, the researchers responsible for the study relied on a secondary analysis of data from 1,713 people aged 50 or over diagnosed with heart failure with preserved ejection fraction, which were part of the TOPCAT trial.
Actually, it was a phase III, randomized, double-blind, placebo-controlled study, whose main objective was to find out if the drug spironolactone could be effective in treating the symptoms of these patients. It is one of the basic pillars in other forms of heart failure, such as reduced ejection fraction.
Furthermore, within the same trial, patients were asked how much salt they usually added to cooking staples such as rice, pasta and potatoes, soup, meat and vegetables. It was scored as 0 points (none), 1 point (1/8 teaspoon), 2 points (1/4 teaspoon), and 3 points (1/2 teaspoon).
Their health status was also monitored for the following 3 years, taking into account data on mortality from cardiovascular disease or hospital admission for heart failure, in addition to other causes of mortality.
According to the study data, half of the participants (816) did not use salt for cooking. Also they weighed more and they had lower diastolic blood pressure (70 mmHg) than those who ate more salt.
On the other hand, precisely the patients who consumed less salt they were also the ones more had been admitted to hospital Because of their heart failure, they were more likely to have type 2 diabetes, worse kidney function, and were more likely to take drugs to improve their heart failure. Likewise, they were the ones who tended to worsen the most, suffering a reduced ejection fraction.
On the other hand, patients who had a salt usage score greater than 0 they had a lower risk of being hospitalized, a lower chance of death from any cause, and a lower chance of death from cardiovascular disease in particular.
Likewise, the patients aged 70 years or younger they were the ones who seemed to benefit most from adding salt to their meals, compared to the older ones. Furthermore, patients of black and other ethnicities also benefited more from adding salt to their meals, compared to the white ones. There were no differences by sex, or by use or not of medications for heart failure.
What limitations, the researchers remind that this is an observational study and not a controlled clinical trial where a cause-effect can be objectified. Furthermore, salt intake was self-reported and not controlled by the investigators, and a reverse causality: that precisely the patients who already have worse health are the ones who restrict salt more than those who are in better conditions.
Usually, control the consumption of salt and not fall into an abuse it is usually the best option to reduce both blood pressure and cardiovascular risk in general, according to the researchers. But in the case of heart failure things are not so easy: Reducing salt too much can make things worse instead of better, so you should keep your intake adequate and in balance.
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