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Identifying predictors of high sodium excretion in patients with heart failure: a mixed effect analysis of
Ruth Masterson Creber1, Maxim Topaz2, Terry A Lennie3
1School of Nursing, University of Pennsylvania USA rumaster@nursing.upenn.edu.
Background:
A low-sodium diet is a core component of heart failure self-care but patients have difficulty following the diet.
Aim:
The aim of this study was to identify predictors of higher than recommended sodium excretion among patients with heart failure.
Methods:
The World Health Organization Five Dimensions of Adherence model was used to guide analysis of existing data collected from a prospective, longitudinal study of 280 community-dwelling adults with previously or currently symptomatic heart failure. Sodium excretion was measured objectively using 24-hour urine sodium measured at three time points over six months. A mixed effect logistic model identified predictors of higher than recommended sodium excretion.
Results:
The adjusted odds of higher sodium excretion were 2.90, (95% confidence interval (CI): 1.15-4.25, p<0.001) for patients who were obese; 2.80 (95% CI: 1.33-5.89, p=0.007) for patients with diabetes; and 2.22 (95% CI: 1.09-4.53, p=0.028) for patients who were cognitively intact.
Conclusion:
Three factors were associated with excess sodium excretion and two factors, obesity and diabetes, are modifiable by changing dietary food patterns.
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