Dietary Sodium Intake is Predicted by Antihypertensive Medication Regimen in Patients With Heart Failure.
Jennifer L Smith, Terry A Lennie, Misook L Chung and 1 others
PMID 30855313WHAT IT FOUND
Patients with heart failure prescribed ACE inhibitors, often with diuretics, beta blockers, or ARBs, ate about 13% more sodium per kcal than those not prescribed ACE inhibitors.
This was an observational association, not proof the drug caused it.
Key findings
01Patients prescribed ACE inhibitors consumed approximately 13% more sodium per kcal than patients not prescribed ACE inhibitors (1.8 ± 0.55 mg sodium/kcal vs. 1.6 ± 0.43 mg sodium/kcal).
02After controlling for age, gender, ethnicity, NYHA class, smoking, beta blockers, ARBs and diuretics, ACE inhibitor prescription predicted higher sodium density (b = .230, p = .011).
03No other medications predicted sodium density, and BMI was the only other controlled variable that did (b = .018, p = .002).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational analysis, not a randomized trial, so it cannot show that ACE inhibitors caused higher sodium intake. Medication use was based on patient-reported lists during interviews, with no measure of adherence, so the study did not know whether patients took the prescribed drugs as directed. There was no objective test of salt taste sensitivity, so the proposed taste mechanism was not measured. The analysis used baseline food diaries from a longitudinal study, so it describes one time point rather than change over time. The sample was mostly White males recruited from three academic outpatient centers in the southeastern and Midwestern United States, so it may not apply to other groups. Food intake was measured by self-recorded diaries, although they were weighed and verified with a dietitian.
Declared interests
The authors declared no conflicts of interest. The article is listed as receiving NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that ACE inhibitors caused patients to eat more salt or that stopping them would lower sodium intake. The study was observational, used reported medication lists without adherence, and did not measure salt taste sensitivity.