Recommendation 73: We suggest that patients with heart failure should restrict their dietary salt intake to between 2 g/day and 3 g/day (Weak Recommendation, Low Quality Evidence).
Practical tip:
- The optimal quantity of salt in the diet is still a subject of debate. The amount should be adapted to the clinical situation, the severity of symptoms and baseline consumption without interfering with other nutritional content.
Recommendation 74: We suggest daily morning weight should be monitored in patients with heart failure, with fluid retention or congestion that is not easily controlled with diuretics, or in patients with significant renal dysfunction (Weak Recommendation, Low Quality Evidence).
Practical tip:
- Weight should be closely monitored for unstable or frail patients. Any rapid weight gain (i.e. > 1.5 or 2 kg) should prompt a rapid medical visit. Weight loss should also be addressed medically.
Recommendation 75: We suggest that restriction of daily fluid intake to approximately 2 L/day should be considered for patients with fluid retention or congestion that is not easily controlled with diuretics (Weak Recommendation, Low Quality Evidence).
Practical tips:
- The appropriate quantity of fluid intake is also a subject of debate. Strict limits should be imposed when there is clear fluid overload or demonstrated sensitivity to fluid intake.
- Severely limiting daily fluid intake to < 1.5 L may have adverse consequences on nutrition, renal function, quality of life without known additional benefit and should be applied selectively.
- Special consideration for hyponatremic patients should be applied.
- Alcohol intake should be avoided if it is a precipitating or contributing factor.
- Patients should quit smoking and a referral for counselling should be offered.