Reduced Salt Intake for Heart Failure: A Systematic Review | Cardiology | JAMA Internal Medicine | JAMA Network

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Conclusions and Relevance  Limited evidence of clinical improvement was available among outpatients who reduced dietary salt intake, and evidence was inconclusive for inpatients. Overall, a paucity of robust high-quality evidence to support or refute current guidance was available. This review suggests that well-designed, adequately powered studies are needed to reduce uncertainty about the use of this intervention.


Al-Mohammad  A, Mant  J.  The diagnosis and management of chronic heart failure: review following the publication of the NICE guidelines.  Heart. 2011;97(5):411-416. doi:10.1136/hrt.2010.214999

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Eat more salt and Live longer (especially if you have had a cardiovascular event)

04:00 – Funnel plost
– Publication Bias

08:20 – Causation vs
Association Studies
09:50 – journal NEJM
back in 1972
there
is a bit of concern about the low salt diet. You can lower blood pressure okay
nobody’s disputing that but there’s a price to pay, you’re going to raise a
renin and aldosterone levels  fairly
substantially. So while you may lower your blood pressure you may actually put
yourself at higher risk have coronary artery disease.
10:39 – Intrasalt
Study (the main reason for recent advice to lower salt comsumption)
17:00 – Salt and
Mortality.
If
you eat less salt, you are more likely to die
As
you take a high-salt diet your mortality, goes down
People
as you take more more salt, cardiovascular disease goes down
20:20 – People with
high blood pressure, the people the guideline tells to eat less salt.
 Cardiovascular event rate for people as they
take more more salt their cardiovascular 
evnt rate goes down and down
23:20 – Journal of
the American Medical Association
They
took 3,685 people and they followed them for seven point nine year
You
had 23 times increase in your cardiac event ray when you take a low-salt diet,
it looks pretty bad
25:10 – Another
cochran review
there
was one group that it looked like urs actually very harmful to follow a
low-salt diet back group was the cardiac patients, so the people with heart
failure the ones I you all tell to eat a low salt diet, they seem to do much
worse, much worse than everybody else
25:30 – Potential
Harm From Too Little Salt Intake (The National Academies of Sciences)
Especially
for those people with heart failure you want to be very very careful because
the low salt diet might be extremely harmful to you okay it’s not only not good
for you but it might be actually very harmful to you and that everything else
was that there was a really enough
Evidence
indicates that low sodium intake may lead to risk of adverse health effects
among those with mid- to late-stage heart failure who are receiving aggressive
treatment for their disease
27:10 – Tradeoffs
for low sodium intake
Blood
Pressure – 3.85 % Decrease (best-case scenario)
Renin (hormone) + 24.3 % Increase
Aldosterone (hormone) + 24.5 % Increase
Adrenaline (hormone) + 9 % Increase
28:20 – The modern
treatment for atherosclerosis
ReninRenin
inhibitors
are used to treat hypertension
Aldosteronespironolactone, ARBs & ACE Inhibitors to treat hogh levels
og Aldosterone

Adrenaline – is blocked with Beta Blocker

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