Low-Salt Diet Intervention Succeeds While Also Failing

Sodium-restricted Dietary Approaches to Stop Hypertension (DASH/SRD) meals didn't significantly improve quality of life of for geriatric heart failure patients in a small randomized trial, but there were encouraging signals of improved symptoms, researchers said here. Currently recommended by hypertension guidelines, the DASH regimen has been associated with lower mortality in existing heart failure. Researchers took it one step further by creating sodium-restricted DASH meals, delivered pre-made to patients, containing 1,500 mg sodium per day and varying levels of potassium depending on renal function and use of mineralocorticoid antagonists. In the first randomized study to test whether pre-made, low-sodium meals could improve outcomes, patients got usual diet (n=33) or home-delivered DASH/SRD meals (n=33). Four weeks post-discharge, the latter saw Kansas City Cardiomyopathy Questionnaire (KCCQ) summary scores jump a mean 15 points to about 57 (P<0.001), according to Scott L. Hummel, MD, MS, of the University of Michigan in Ann Arbor, on behalf of the Geriatric Out-of-Hospital Randomized Meal Trial in Heart Failure (GOURMET-HF) investigators. But KCCQ summary scores also improved a by a mean 10 points in the usual-food group (P=0.001), translating to no significant between-group difference (P=0.37), he told the audience here at the late-breaking trial session of the Heart Failure Society of America meeting. Coming closer to statistical significance, but falling just short, were differences in the KCCQ clinical summary, which takes into account heart failure symptoms and physical limitations. The low-sodium DASH diet brought mean scores up roughly 20 points to about 65, compared to an approximately 15-point gain among controls (P=0.053). "Larger studies are warranted to investigate how dedicated nutritional support affects functional capacity and readmissions in post-discharge patients with heart failure," said Hummel. https://www.medpagetoday.com/mastery-of-medicine/art-and-science-of-hf/68038?xid=nl_mpt_DHE_2017-09-21&eun=g721819d0r&pos=0