Sodium restrictive diet associated with decrease in HF-related readmissions
Home-delivered sodium-restricted Dietary Approaches to Stop Hypertension (DASH/SRD) meals after heart failure (HF) hospitalizations appeared safe in some patients, has the potential to improve HF symptoms and can reduce readmissions, according to new research in Circulation: Heart Failure.
Patients with HF typically experience malnutrition and also have an excess of dietary sodium, which may worsen HF outcomes.
Researchers—led by Scott L. Hummel, MD, MS, of the University of Michigan Frankel Cardiovascular Center in Ann Arbor, Michigan—initiated the GOURMET-HF (Geriatric Out-of-Hospital Randomized Meal Trial in Heart Failure) study to gauge whether a low-sodium, “nutritionally complete” diet would impact outcomes and disease-specific quality of life in HF patients.
The researchers primarily sought to determine a change in the Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score, which assesses HF-related physical limitations, symptoms, self-efficacy and social interference.
Randomized patients older than 55 were sent three DASH/SRD meals, snacks and beverages for 12 weeks at three different study sites. Baseline dietary patterns and nutrient intake were assessed during hospital discharge. The cohort included 107 patients, of which 66 were randomly chosen to get the DASH/SRD meals. All patients were followed for 12 weeks to determine the rates of death, hospital readmission and any diet-related adverse events.
“Although not meeting its primary outcome, this pilot study demonstrated trends for efficacy in several domains important to recently hospitalized patients with HF and their providers,” Hummel and colleagues wrote. “These outcomes included symptoms and physical limitations related to HF, as well as rehospitalization burden.”
The KCCQ summary score, or the disease-specific quality of life, increased similarly between groups. The increase, however, tended to be nine points greater in the DASH/SRD participants—indicating the study did not meet its primary outcome.
The researchers found diet-related adverse events were uncommon. Interestingly, only 11 percent of DASH/SRD participants had HF-related hospital readmissions, compared to 27 percent in the control group. And within the first 30 days of discharge from the hospital, the DASH/SRD group spent 17 cumulative days re-hospitalized, compared to 55 days in the control group.
Overall, the researchers found, sodium restriction did not have a significant impact on blood pressure, serum creatinine or serum potassium in either group.
“The GOURMET-HF results are hypothesis-generating and establish the rationale for conducting a larger study of direct dietary support in patients with HF after hospital discharge,” the researchers concluded. “Such a trial would ideally be powered to assess this strategy’s impact on hospital readmission burden. In addition, the complexity and costs of this intervention, as well as its feasibility and efficacy across patients of diverse demographics and socioeconomic status, would be important considerations in a future trial.”
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.