A pinch of reality: Landmark heart failure study upends century-old salt doctrine
A major international trial found that while reducing sodium improves patients’ daily symptoms and quality of life, it does not reduce hospitalizations, emergency visits or mortality.
Led by Dr. Justin Ezekowitz, it randomly assigned over 800 heart failure patients across six countries to either receive standard care or intensive counseling to limit sodium to 1,500 mg per day.
The intervention successfully changed behavior but not the hardest health outcomes. The counseled group significantly reduced sodium intake, primarily by avoiding processed foods, yet showed no statistical difference in death or major clinical events compared to the standard care group.
Patients on the low-sodium diet reported meaningful improvements in swelling, fatigue, coughing and overall quality of life, indicating the value lies in improving daily living.
The research forces a shift from dogma to data, suggesting public health guidelines must move away from universal warnings and toward honest, targeted prescriptions based on individual patient goals.
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