Three gram sodium intake is associated with longer event-free survival only in patients with advanced heart failure

Terry A. Lennie, Eun Kyeung Song, Jia Rong Wu, Misook L. Chung, Sandra B. Dunbar, Susan J. Pressler, Debra K. Moser

Research output: Contribution to journalArticlepeer-review

113 Scopus citations


Background: There is limited evidence to support the recommendation that patients with heart failure (HF) restrict sodium intake. The purpose of this study was to compare differences in cardiac event-free survival between patients with sodium intake above and below 3 g. Methods: A total of 302 patients with HF (67% male, 62 ± 12 years, 54% New York Heart Association [NYHA] Class III/IV, ejection fraction 34 ± 14%) collected a 24-hour urine sodium (UNa) to indicate sodium intake. Patients were divided into 2 groups using a 3-g UNa cutpoint and stratified by NYHA Class (I/II vs. III/IV). Event-free survival for 12 months was determined by patient or family interviews and medical record review. Differences in cardiac event-free survival were determined by Kaplan-Meier survival curve with log-rank test and Cox hazard regression. Results: The Cox regression hazard ratio for 24-hour UNa ≥ 3 g in NYHA Class I/II was 0.44 (95% confidence interval [CI] = 0.20-0.97) and 2.54 (95% CI = 1.10-5.84) for NYHA III/IV after controlling for age, gender, HF etiology, body mass index, ejection fraction, and total comorbidity score. Conclusions: These data suggest that 3 g dietary sodium restriction may be most appropriate for patients in NYHA functional Classes III and IV.

Original languageEnglish
Pages (from-to)325-330
Number of pages6
JournalJournal of Cardiac Failure
Issue number4
StatePublished - Apr 2011

Bibliographical note

Funding Information:
Supported in part by a grant from NIH NINR R01 NR 009280 , General Clinical Research Centers at University of Kentucky : M01RR02602 , Emory University : M01RR0039 , and Indiana University : MO1 RR000750 and by NIH, NINR Center grant 1P20NR010679 to the University of Kentucky College of Nursing.


  • Diet
  • NYHA class
  • sodium restriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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