Eating about 4,200 mg sodium a day may raise heart failure risk 15%

Excessive consumption of dietary sodium (salt) is a significant, independent risk factor for new-onset heart failure, according to a report from Vanderbilt Health, published in the Journal of the American College of Cardiology: Advances.

In a group of predominantly Black and low-income people from the southeastern United States, consuming a population average of about 4,200 milligrams of dietary sodium a day (the recommended maximum is 2,300 milligrams) was associated with a 15% increase in the risk of incident (new) cases of heart failure.

“Even modest reductions in sodium consumption may significantly reduce the burden of heart failure in this high-risk population,” the researchers report.

Reducing dietary salt consumption is not a simple matter, however, cautioned the paper’s corresponding author, Deepak Gupta, MD, MSCI, associate professor of Medicine and director of the Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC).

Multilevel, public health strategies may be required to address grocery store availability and limited transportation options that make it difficult for residents of many low-income, high-risk communities to access healthier food options, Gupta said.

Leonie Dupuis, MD, a third-year resident physician in internal medicine at Vanderbilt Health, is first author of the paper, which analyzed dietary and health records of more than 25,300 participants in the Southern Community Cohort Study.

The SCCS has tracked the health of predominantly Black and low-income residents of 12 southeastern states since 2001. Most of them were enrolled in this and other studies through community health centers.

Average daily sodium consumption in this group was 4,269 milligrams per day, well above the daily, 2,300-milligram limit recommended by federal dietary guidelines.

The increased risk of heart failure linked to sodium was independent of sociodemographic factors, including diet quality and caloric intake, as well as health conditions such as high blood pressure and high lipid blood levels.

Heart failure contributes to 425,000 deaths in the United States each year. The cost of caring for the estimated 1 million new cases of heart failure diagnosed annually runs into the tens of billions of dollars.

Even a modest reduction in dietary salt, to 4,000 milligrams a day or less, could reduce heart failure cases by 6.6% over 10 years, the researchers predicted. That would translate into fewer deaths from heart failure and a nearly $2-billion-a-year reduction in national health expenditures.