Things We Do For No Reason™: Low salt diets for patients with acute heart failure

Low salt diets are a common practice in the management of acute heart failure (HF), founded in classical pathophysiologic teaching related to neurohormonal alterations and associated sodium and fluid avidity in HF. However, trials comparing dietary salt restriction in patients hospitalized with acute HF showed no improvement in outcomes for those randomized to lower salt targets. Outpatient HF data also fails to show a reduction in HF admissions and mortality with salt restrictions. Routine use of dietary salt restrictions, especially those that are stringent, should be avoided to improve patient outcomes and experience.