Dietary Sodium Restriction in Patients with Heart Failure

This Clinical Decisions feature presents a case of a 67-year-old man with hypertension, obesity, and stage C heart failure admitted for decompensation. He expresses interest in dietary changes during discharge counseling. The article poses two options: (1) recommend adherence to a low-sodium diet and (2) recommend no sodium restriction. Experts present arguments for both. Proponents cite guidelines (AHA/ACC) and epidemiologic data supporting <2300 mg/day sodium intake, especially in patients with hypertension and heart failure. Opponents highlight findings from the SODIUM-HF trial, which showed no significant benefit in major outcomes with strict sodium restriction and call for broader dietary improvements rather than sodium-focused changes. The case emphasizes real-world complexity and the evolving nature of dietary recommendations in heart failure care.

This Clinical Decisions feature presents a case of a 67-year-old man with hypertension, obesity, and stage C heart failure admitted for decompensation. He expresses interest in dietary changes during discharge counseling. The article poses two options: (1) recommend adherence to a low-sodium diet and (2) recommend no sodium restriction. Experts present arguments for both. Proponents cite guidelines (AHA/ACC) and epidemiologic data supporting <2300 mg/day sodium intake, especially in patients with hypertension and heart failure. Opponents highlight findings from the SODIUM-HF trial, which showed no significant benefit in major outcomes with strict sodium restriction and call for broader dietary improvements rather than sodium-focused changes. The case emphasizes real-world complexity and the evolving nature of dietary recommendations in heart failure care.