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Heart failure is often considered as an international public health concern due to its increasing prevalence and direct health costs. The aims of HF therapy are to reduce mortality and morbidity, which includes relieving symptoms and signs and improving quality of life. Currently there is still a gap of evidence regarding sodium restriction diet as non-pharmacological and non-interventional therapy. The aim of this report is to perform a critical appraisal to analyze whether sodium restriction diet reduce the symptoms of heart failure compared to no restriction in the diet.
Comprehensive computer-based literature search was performed on January 30, 2016 using PubMed, EMBASE, and the Cochrane Library. All abstracts and title from the initial search results were screened, reviewed, and appraised using critical appraisal worksheets by Center of Evidence-Based Medicine, University of Oxford.
Three RCTs met the inclusion criteria and were considered eligible for this case report. In patients with chronic heart failure, the median quality of life score after 6 months significantly increased in the low-sodium diet group. In addition, improvement in the primary merged endpoint which includes NYHA class and quality of life was seen in 51% of the patients in the sodium-restricted diet group. In contrast, in patients with acute decomplensated heart failiure, there were no significant differences in the change in clinical congestion score (CCS) from baseline to 3-day reassessment.
In patients with chronic heart failure, quality of life improvement and NYHA class improvement were seen in patients with sodium-restricted diet.. Further research with larger sample size, strict allocation and blinding in intervention and control group, and extensive follow-up period are needed to establish a firm heart failure nutrition guideline.