Abstract

Aim. The aim of this paper is to review studies related to sodium restriction and adherence to this restriction in patients with heart failure.

Background. In the last decade, there has been a dramatic increase in the prevalence and incidence of chronic heart failure. Non-pharmacological and non-surgical therapies in the management of chronic heart failure play an important role, and low sodium intake, by reducing fluid retention, improves symptoms and prevents worsening of the disease, but adherence to nutritional regimes is often less than adherence to medications.

Method. We reviewed studies published over the recent 15 years regarding sodium restriction in patients with heart failure. These were searched out through scientific databases, including PubMed and Science Direct by the keywords adherence, chronic  heart failure, low-sodium diet, sodium restriction, low salt diet and their Persian equivalents.

Findings. In the reviewed studies, sodium intake assay and patient's adherence to sodium restriction were different. Although sodium restriction is known as the basic management of heart failure, butthere are not consensus about its usefulness. It was also found that there is no specific guidelines for sodium restriction in heart failure, and that a small percentage of patients follow sodium restriction. Few studies have been conducted regarding related factors of adherence to the sodium restriction diet in patients with heart failure. Also, non-pharmacological methods including education and counseling have not been successful in improving patients’ adherence.

Conclusion. Further research with higher methodological quality, larger sample size and the use of appropriate and accurate approach to measure sodium intake is needed. To achieve a sodium restriction diet is possible, but difficult. Although, there is no consensus on the exact amount of the reduction of daily sodium intake, but seems that reduction in sodium intake can improve symptoms and quality of life in patients with heart failure. Theory-based and family-based interventions may be able to help improving patients’ adherence to sodium restriction diet, although more studies are essential to be conducted.