Is it time to stop recommending strict salt restriction for people with heart failure?

For decades, it was thought that people with heart failure should significantly reduce their dietary salt intake, but some studies suggest that salt restriction could be harmful for these patients.

A recent review in the European Journal of Clinical Investigation which evaluated all relevant studies published between 2000 and 2023 concluded that there was no proven clinical benefit to this strategy for patients with heart failure.

Most relevant randomized trials were small and only one large randomized clinical trial was terminated early due to futility. Although moderate to strict salt restriction was associated with better quality of life and functional status, it did not affect mortality and hospitalization rates in patients with heart failure.

“Physicians are often hesitant to make changes to age-old principles that have no real scientific basis; however, when valid new evidence surfaces, we should make an effort to adopt it,” said author Paolo Raggi MD , Ph.D., from the University. of Alberta.