Dietary Sodium Intake is Predicted by Antihypertensive Medication Regimen in Patients with Heart Failure

Jennifer L. Smith, Terry A. Lennie, Misook L. Chung, Gia Mudd-Martin

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background Low-sodium diet adherence is foundational to heart failure (HF) self-management. Altered salt taste perception caused by angiotensin-converting enzyme (ACE) inhibitors commonly prescribed to patients with HF may increase sodium consumption. We hypothesized sodium intake, indicated by dietary sodium density, would be significantly higher among patients with HF prescribed ACE inhibitors compared with those not prescribed the drug. Objective The aim of this study was to assess the association between prescribed ACE inhibitors and dietary sodium density in patients with HF. Methods We conducted a secondary analysis of baseline data from patients with HF in an observational longitudinal study. Sodium density was derived by dividing averaged daily sodium intake from 4-day food diaries by averaged kilocalories consumed. Medical chart review was conducted to ascertain prescribed medications. Patients were categorized as prescribed and not prescribed an ACE inhibitor. t Tests were conducted to compare sodium intake between groups, and linear regression was conducted to examine whether prescribed ACE inhibitors independently predicted sodium density controlling for age, gender, New York Heart Association class, prescribed diuretics, and β-blockers. Results Analyses included 255 patients with HF aged 61 ± 12 years, with 67% male, 44% New York Heart Association class III/IV, and 68% prescribed an ACE inhibitor. Compared with those not prescribed an ACE inhibitor, 13% more sodium per kilocalorie was consumed by patients prescribed an ACE inhibitor. Prescribed ACE inhibitor independently predicted dietary sodium density (β = 0.238, P =.009). Conclusions Sodium intake was higher among patients prescribed ACE inhibitors. Interventions to assist patients with HF with dietary sodium adherence can be informed by assessing medication regimens.

Original languageEnglish
Pages (from-to)313-318
Number of pages6
JournalJournal of Cardiovascular Nursing
Issue number4
StatePublished - Jul 1 2019

Bibliographical note

Funding Information:
The parent study for this secondary analysis received funding from the following sources: NIH R01 NR 009280, NIH P20 NR 010679, Clarion Health Partners (Indiana), and the GCRC UK: M01 RR02602, Emory: M01 RR0039, and Indiana: M01 RR000750. The authors have no conflicts of interest to disclose. Correspondence Jennifer L. Smith, PhD, RN, 2201 Regency Rd, Ste 404, Lexington, KY 40503 ( DOI: 10.1097/JCN.0000000000000570

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.


  • ACE inhibitor
  • Heart failure
  • Salt taste
  • Sodium consumption
  • Sodium density

ASJC Scopus subject areas

  • Medicine (all)


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