Diet Therapy – ABC CARDIOL

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Editorial

Evaluating Sodium Restriction in Heart Failure

Although salt and water retention plays a crucial role in heart failure (HF) pathophysiology, controversy still exists about dietary salt restriction in the treatment of HF patients. Small clinical studies have suggested that excessive sodium restriction (< 5 g of salt per day), as compared with normal-sodium diet (approximately 7 g of salt per day), may be associated with deleterious effects in patients with chronic HF, including increased neurohormonal activation, and higher hospitalization and mortality rates.^,

A recent meta-analysis of nine studies involving 479 HF patients undergoing dietary sodium restriction was inconclusive for the recommendation of this strategy in hospitalized patients. None of the studies analyzed in the meta-analysis included hard endpoints such as all-cause death or cardiovascular mortality. However, a modest tendency for improvement of functional class was observed in outpatients undergoing sodium restriction intake. The author reinforces the need for randomized, prospective studies including large sample sizes, evaluating the effect of different regimens of sodium intake on relevant outcomes to build evidence base for detailed recommendations.

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Artigo Original

Glomerular filtration and associated factors in hypertensive individuals treated at primary care level

Ana Karina Teixeira da Cunha França et al. Alcione Miranda dos Santos Isabela Leal Calado Elisângela Milhomem dos Santos … Poliana Coelho Cabral João Victor Leal Salgado Noemia Perli Goldraich Natalino Salgado Filho

BACKGROUND: In Brazil, arterial hypertension (AH) constitutes one of the main risk factors for chronic kidney disease (CKD). The monitoring of glomerular filtration (GF) is recommended for the assessment of kidney function in hypertensive individuals, as GF decrease precedes symptom onset. OBJECTIVE: To assess GF and its associated factors in hypertensive individuals. METHODS: A cross-sectional study was carried out from January to June 2008 in 297 individuals with arterial hypertension (AH) with or without diabetes mellitus (DM), treated at a primary care facility in the city of São Luís, Maranhão. Patients older than 20 years and of both sexes were included in the study. Sociodemographic and nutritional status data, GF rate and microalbuminuria levels in 24-hour urine were assessed, as well as blood pressure, glucose and serum creatinine levels and a lipidogram. RESULTS: Mean age was 60.6 × 11.5 years, with a predominance of the female sex (75.1%), overweight/obesity (65.0%) and large waist circumference (60.6%). The prevalence of GF 65 years, which remained after adjustment. For the AH group with DM, there was an association between reduced GF and age > 65 years, smoking habit and obesity. However, after the adjustment, age and smoking habit remained as associated factors. CONCLUSION: In these patients, the prevalence of GF 65 years and smoking habit were shown to be factors associated to GF. This reinforces the need to systematically evaluate GF in hypertensive individuals, aiming at the secondary prevention of chronic kidney disease.

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Evaluating Sodium Restriction in Heart Failure

Glomerular filtration and associated factors in hypertensive individuals treated at primary care level

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Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)