Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC

Wilfried Mullens^{1

2}, Kevin Damman³, Sebastiaan Dhont^{1

2}, Debasish Banerjee⁴, Antoni Bayes-Genis⁵, Antonio Cannata⁶, Ovidiu Chioncel⁷, Maja Cikes⁸, Justin Ezekowitz⁹, Andreas J Flammer¹⁰, Pieter Martens^{1

11}, Alexandre Mebazaa¹², Robert J Mentz¹³, Òscar Miró¹⁴, Brenda Moura¹⁵, Julio Nunez¹⁶, Jozine M Ter Maaten³, Jeffrey Testani¹⁷, Roland van Kimmenade¹⁸, Frederik H Verbrugge^{19

20}, Marco Metra²¹, Giuseppe M C Rosano^{22

23}, Gerasimos Filippatos²⁴

Affiliations

¹ Department of Cardiology, Ziekenhuis Oost-Limburg A.V, Genk, Belgium.
² Hasselt University, Hasselt, Belgium.
³ University of Groningen, Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands.
⁴ Renal and Transplantation Unit, St George's University Hospitals National Health Service Foundation Trust, London, UK.
⁵ Heart Institute, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERCV, Barcelona, Spain.
⁶ School of Cardiovascular Medicine and Sciences, King's College London, London, UK.
⁷ Emergency Institute for Cardiovascular Diseases, University of Medicine Carol Davila, Bucharest, Romania.
⁸ Department of Cardiovascular Diseases, University of Zagreb School of Medicine & University Hospital Center Zagreb, Zagreb, Croatia.
⁹ Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, AB, Canada.
¹⁰ Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
¹¹ Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
¹² Université de Paris, MASCOT, INSERM, Paris, France.
¹³ Duke Clinical Research Institute, Durham, NC, USA.
¹⁴ Department of Emergency, Hospital Clínic, 'Processes and Pathologies, Emergencies Research Group' IDIBAPS, University of Barcelona, Barcelona, Spain.
¹⁵ Hospital das Forças Armadas and Cintesis - Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
¹⁶ Cardiology Department and Heart Failure Unit, Hospital Clínico Universitario de Valencia, University of Valencia, INCLIVA, Valencia, Spain.
¹⁷ Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
¹⁸ Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
¹⁹ Centre for Cardiovascular Diseases, University Hospital Brussels, Jette, Belgium.
²⁰ Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium.
²¹ Cardiology, ASST Spedali Civili, and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
²² Cardiology Clinical Academic Group, Molecular and Clinical Research Institute, St Georges University of London, London, UK.
²³ Cardiology, San Raffaele Cassino, Rome, Italy.
²⁴ Department of Cardiology, Attikon University Hospital, Athens, Greece.

PMID: 38606657
DOI: 10.1002/ejhf.3244

Free article

Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC

Wilfried Mullens et al. Eur J Heart Fail. 2024 Apr.

Free article

. 2024 Apr;26(4):730-741.

doi: 10.1002/ejhf.3244. Epub 2024 Apr 12.

Authors

Affiliations

¹ Department of Cardiology, Ziekenhuis Oost-Limburg A.V, Genk, Belgium.
² Hasselt University, Hasselt, Belgium.
³ University of Groningen, Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands.
⁴ Renal and Transplantation Unit, St George's University Hospitals National Health Service Foundation Trust, London, UK.
⁵ Heart Institute, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERCV, Barcelona, Spain.
⁶ School of Cardiovascular Medicine and Sciences, King's College London, London, UK.
⁷ Emergency Institute for Cardiovascular Diseases, University of Medicine Carol Davila, Bucharest, Romania.
⁸ Department of Cardiovascular Diseases, University of Zagreb School of Medicine & University Hospital Center Zagreb, Zagreb, Croatia.
⁹ Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, AB, Canada.
¹⁰ Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
¹¹ Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
¹² Université de Paris, MASCOT, INSERM, Paris, France.
¹³ Duke Clinical Research Institute, Durham, NC, USA.
¹⁴ Department of Emergency, Hospital Clínic, 'Processes and Pathologies, Emergencies Research Group' IDIBAPS, University of Barcelona, Barcelona, Spain.
¹⁵ Hospital das Forças Armadas and Cintesis - Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
¹⁶ Cardiology Department and Heart Failure Unit, Hospital Clínico Universitario de Valencia, University of Valencia, INCLIVA, Valencia, Spain.
¹⁷ Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
¹⁸ Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
¹⁹ Centre for Cardiovascular Diseases, University Hospital Brussels, Jette, Belgium.
²⁰ Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium.
²¹ Cardiology, ASST Spedali Civili, and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
²² Cardiology Clinical Academic Group, Molecular and Clinical Research Institute, St Georges University of London, London, UK.
²³ Cardiology, San Raffaele Cassino, Rome, Italy.
²⁴ Department of Cardiology, Attikon University Hospital, Athens, Greece.

PMID: 38606657
DOI: 10.1002/ejhf.3244

Abstract

Sodium and fluid restriction has traditionally been advocated in patients with heart failure (HF) due to their sodium and water avid state. However, most evidence regarding the altered sodium handling, fluid homeostasis and congestion-related signs and symptoms in patients with HF originates from untreated patient cohorts and physiological investigations. Recent data challenge the beneficial role of dietary sodium and fluid restriction in HF. Consequently, the European Society of Cardiology HF guidelines have gradually downgraded these recommendations over time, now advising for the limitation of salt intake to no more than 5 g/day in patients with HF, while contemplating fluid restriction of 1.5-2 L/day only in selected patients. Therefore, the objective of this clinical consensus statement is to provide advice on fluid and sodium intake in patients with acute and chronic HF, based on contemporary evidence and expert opinion.

Keywords: Fluid; Heart failure; Sodium.

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References

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Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC

Affiliations

Dietary sodium and fluid intake in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC

Authors

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Abstract

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LinkOut - more resources

Full Text Sources

Medical

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