High salt intake doubles risk for heart failure

High salt intake was associated with a twofold increase in the risk for heart failure, according to findings recently presented at the European Society of Cardiology Congress in Barcelona.

“The role of salt intake in the development of heart failure is not known. Estimation of individual salt intake is methodologically demanding and therefore, suitable population-based cohorts are rare,” Pekka Jousilahti, MD, PhD, research professor at the National Institute for Health and Welfare, Helsinki, and colleagues wrote in their abstract.

To gather more data, researchers randomly selected 4,630 patients who had participated in two previous studies between 1979 and 2002. The participants had their BP, height and weight measured. Researchers obtained 24-hour urine samples, venous blood samples and a 100 mL urine sample for laboratory analysis, with the latter sample taken at the study’s site.

“The 24-hour sodium extraction is considered as the gold standard for salt intake estimation at individual level,” Jousulahti and colleagues wrote.

The physiological need for salt per person is 2 to 3 g per day, and WHO recommends no more than 5 g of salt per day, according to researchers.

Jousulahti and colleagues divided salt intake into quintiles: less than 6.76 g per day; between 6.77 and 8.80 g per day; between 8.81 and 10.95 g per day; between 10.96 and 13.73 g per day; and more than 13.73 g per day. Researchers stated that 1 g of salt intake was equivalent to 17.1 mmol of sodium excretion. Cox proportional hazard models estimated the risk for a new heart failure event. Participants were followed for 12 years. Researchers adjusted for age, sex, study year and area.

When compared to the first quintile of salt intake, Jousilahti and colleagues found that the HR for the second quintile was 0.83; for the third quintile it was 1.4; for the fourth quintile it was 1.7; and for the fifth quintile it was 2.1 (P = .002). After additional adjustment for BMI, systolic BP and serum total cholesterol level, the HRs were as follows: second quintile, 1.13; third quintile, 1.45; fourth quintile, 1.56; and fifth quintile, 1.75 (P = .009).

“The heart does not like salt. High salt intake markedly increases the risk of heart failure,” Jousilahti said in a press release. “This salt-related increase in heart failure risk was independent of blood pressure. Studies in larger, pooled population cohorts are needed to make more detailed estimations of the increased heart failure risk associated with consuming salt." – by Janel Miller

Reference: Jousilahti P, et al. Salt intake and the risk of heart failure. Presented at European Society of Cardiology Congress; Aug. 26-30, 2017; Barcelona.

Disclosures: Healio Family Medicine was unable to confirm researchers’ relevant financial disclosures at the time of publication.