Abstract 15681: Impact of Dietary Sodium Restriction on Heart Failure Outcomes: A Systematic Review and Meta-Analysis

Introduction: Although heart failure (HF) guidelines emphasized dietary sodium restriction, the recommendation was based on limited evidence. We analyzed the impact of dietary sodium restriction on HF outcomes and quality of life (QoL) by systematically reviewing the available literature to-date. Methods: MEDLINE and SCOPUS were queried from inception till April 2022 for randomized controlled trials (RCTs) and observational studies with sodium restriction (≤1500-3000mg) as an intervention/comparator and assessing its impact (or association) on HF outcomes. Data about HF-related hospitalizations, all-cause mortality and QoL (via the Kansas City Cardiomyopathy Questionnaire) was extracted, pooled and analyzed. Forest plots were created based on random effects model. Results: Twelve studies (n= 4637 patients) were included in our analysis with a median follow-up time of 6 months. The pooled analysis demonstrated no difference in HF hospitalizations between the sodium-restricted and unrestricted groups (OR = 1.30 [0.81-2.10] P<0.28) (Figure 1a). However, a significantly higher risk of all-cause mortality was observed associated with sodium-restriction (OR = 1.68, 95% CI: 1.26-2.24, P< 0.0004) (Figure 1b). Dietary sodium restriction was not associated with QoL (mean difference = 0.14, 95% CI: -0.07-0.35, P< 0.18). (Figure 1c). Conclusions: Our observations suggest that sodium restriction in patients with HF may not improve QoL or reduce hospitalizations, but is associated with increased risk of mortality.