dietary sodium, heart failure, meta-analysis, quality of life, review



  1. Zhu, Chenya MD, APN
  2. Cheng, Ming MD, APN
  3. Su, Yue MD, APN
  4. Ma, Tianyu MD, APN
  5. Lei, Xiaoqing MD, APN
  6. Hou, Yunying PhD, RN


Background: Dietary salt restriction is recommended by many guidelines for patients with heart failure (HF). Quality of life (QoL) is an important end point of this intervention. However, the literature is still limited regarding the effect of dietary salt restriction on QoL in patients with HF.


Aims: We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the effect of dietary sodium restriction on QoL in patients with HF.


Methods: We searched PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, and Cumulative Index to Nursing and Allied Health from the establishment of each database to December 20, 2020. We included randomized controlled trials with sodium restriction as an intervention. The primary outcome was QoL, and the secondary outcomes were mortality, readmission, and fatigue. We obtained the full text of potentially relevant trials, extracted data from the included trials, assessed their risk of bias, and performed a meta-analysis.


Results: We included 10 trials (1011 participants with HF) with 7 days to 83 months of follow-up. Dietary sodium restriction did not improve QoL over the long term (>30 days) (P = .61). The pooled effects showed that this intervention might increase mortality risk (P < .00001). It did not reduce the readmission rate within the short term (<=30 days) (P = .78) but increased the readmission rate over the long term (P = .0003).


Conclusion: Our study did not show that interventions to restrict dietary sodium had a positive effect on patients with HF in terms of QoL, mortality, or readmission.