Eating a Larger Number of High-Salt Foods is Not Associated with Short-Term Risk of Acute Decompensation in Patients with Chronic Heart Failure

• Published in: The Journal of emergency medicine 2013, Vol.44 (1), p.36-45
• Main Authors: Borke, Jesse A., MD, Wyer, Peter C., MD
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Chronic Disease; Diet - adverse effects; dietary sodium; Emergency; Female; heart failure; Heart Failure - etiology; Humans; Logistic Models; Male; Middle Aged; patient adherence; Pilot Projects; Sodium, Dietary - administration & dosage; Sodium, Dietary - adverse effects; Surveys and Questionnaires
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2012.02.081

Abstract Background Risk factors for exacerbation of congestive heart failure have not been consistently validated. Objective Our objective was to examine the role of short-term dietary sodium intake in acute decompensated heart failure. Methods Patients with chronic congestive heart failure presenting to the Emergency Department for either acute decompensated heart failure (cases) or for other reasons (controls) were included in a case-control study. Cases and controls were compared with respect to age, smoking, recent sodium intake, medication nonadherence, coronary artery disease, and hypertension. A food frequency questionnaire was utilized to estimate recent sodium intake, defined as the number of food types consumed in the previous 3 days from the 12 highest-sodium food categories. Results There were 182 patients enrolled. One patient was excluded due to uncertainty about the primary diagnosis. When adjusted for age, smoking, medication nonadherence, coronary artery disease, and hypertension, acute decompensated heart failure was not associated with short-term dietary sodium intake. The odds ratio for acute decompensated heart failure for each increase in the number of high-sodium food types consumed was 1.1 (95% confidence interval 0.9–1.3; p = 0.3). Acute decompensated heart failure was associated with medication nonadherence, with an odds ratio for decompensation of 2.5 (95% confidence interval 1.2–5.1; p = 0.01). Conclusions Patients with chronic congestive heart failure who presented to the Emergency Department with acute decompensated heart failure were no more likely to report consuming a greater number of high-sodium foods in the 3 days before than were patients with chronic congestive heart failure who presented with unrelated symptoms. On the other hand, those who presented with acute decompensated heart failure were significantly more likely to report nonadherence with medications.