Prescription, Compliance, and Burden Associated with Salt-Restricted Diets in Heart Failure Patients: Results from the French National OFICSel Observatory.

Thibaud Damy,Françoise Pousset,Vlad Ciobotaru,Gilbert Habib,Fabrice Bauer,Olivier Lairez,Luc Hittinger,Théo Pezel,Laure Chaufourier,Florence Beauvais,Guillaume Baudry,Emmanuelle Berthelot,Véronique Benedyga,Damien Logeart,P De Groote ,Jacques Yves Gauthier ,Kévin Richard ,Emmanuel Teíger ,Jean‐François Aupetit ,Florian Zorès ,C Taïeb ,Marie‐Christine Iliou ,Étienne Audureau

doi:10.3390/nu14020308

Abstract

(1) Background: There is much debate about the use of salt-restricted diet for managing heart failure (HF). Dietary guidelines are inconsistent and lack evidence. (2) Method: The OFICSel observatory collected data about adults hospitalised for HF. The data, collected using study-specific surveys, were used to describe HF management, including diets, from the cardiologists’ and patients’ perspectives. Cardiologists provided the patients’ clinical, biological, echocardiography, and treatment data, while the patients provided dietary, medical history, sociodemographic, morphometric, quality of life, and burden data (burden scale in restricted diets (BIRD) questionnaire). The differences between the diet recommended by the cardiologist, understood by the patient, and the estimated salt intake (by the patient) and diet burden were assessed. (3) Results: Between March and June 2017, 300 cardiologists enrolled 2822 patients. Most patients (90%) were recommended diets with <6 g of salt/day. Mean daily salt consumption was 4.7 g (standard deviation (SD): 2.4). Only 33% of patients complied with their recommended diet, 34% over-complied, and 19% under-complied (14% unknown). Dietary restrictions in HF patients were associated with increased burden (mean BIRD score of 8.1/48 [SD: 8.8]). (4) Conclusion: Healthcare professionals do not always follow dietary recommendations, and their patients do not always understand and comply with diets recommended. Restrictive diets in HF patients are associated with increased burden. An evidence-based approach to developing and recommending HF-specific diets is required.

Highlights

Worldwide, about 26 million people have heart failure (HF) [1,2]
Health-related quality of life data were collected using the Minnesota Living with Heart failure Questionnaire (MLHFQ), which comprises 21 items divided into physical, emotional, and socioeconomic effects of HF on daily life, each scored on a six-point Likert scale from 0 to 5 [20]
2017, 2822 patients were enrolled by 300 cardiologists from

Summary

Introduction

About 26 million people have heart failure (HF) [1,2]. HF is a major public health concern, with high and increasing rates of hospitalisation and mortality, and is associated with substantial economic burden [3,4,5]. In 2012, the ESC indicated that there was not enough evidence to recommend restricting dietary salt [14]. The American Heart Association (AHA), in 2013, recommended that patients with more severe HF restrict sodium to. The 2016 European Society of Cardiology (ESC) guidelines recommend that HF patients restrict salt consumption to 6 g/day [16]. The 2021 ESC guidelines recommend that diets with salt intake of >5 g/day should be avoided [17]. In 2018, the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand recommended that HF patients limit sodium intake to

Study Design

Data Collection

Statistical Analysis

Characteristics of and

4.4.Discussion

Conclusions