Jennifer L. Smith, PhD, RN Postdoctoral Fellow, College of Nursing, University of Kentucky, Lexington. Terry A. Lennie, PhD, RN, FAHA, FAAN Senior Associate Dean and Professor, College of Nursing, University of Kentucky, Lexington. Misook L. Chung, PhD, RN, FAHA, FAAN Professor, College of Nursing, University of Kentucky, Lexington. Gia Mudd-Martin, PhD, MPH, RN, FAHA Associate Professor, University of Kentucky, College of Nursing Lexington, Kentucky.
J Cardiovasc Nurs. 2019 Jul/Aug;34(4):313-318. doi: 10.1097/JCN.0000000000000570.
Low-sodium diet adherence is foundational to heart failure (HF) self-management. Altered salt taste perception caused by angiotensin-converting enzyme (ACE) inhibitors commonly prescribed to patients with HF may increase sodium consumption. We hypothesized sodium intake, indicated by dietary sodium density, would be significantly higher among patients with HF prescribed ACE inhibitors compared with those not prescribed the drug.
The aim of this study was to assess the association between prescribed ACE inhibitors and dietary sodium density in patients with HF.
We conducted a secondary analysis of baseline data from patients with HF in an observational longitudinal study. Sodium density was derived by dividing averaged daily sodium intake from 4-day food diaries by averaged kilocalories consumed. Medical chart review was conducted to ascertain prescribed medications. Patients were categorized as prescribed and not prescribed an ACE inhibitor. t Tests were conducted to compare sodium intake between groups, and linear regression was conducted to examine whether prescribed ACE inhibitors independently predicted sodium density controlling for age, gender, New York Heart Association class, prescribed diuretics, and β-blockers.
Analyses included 255 patients with HF aged 61 ± 12 years, with 67% male, 44% New York Heart Association class III/IV, and 68% prescribed an ACE inhibitor. Compared with those not prescribed an ACE inhibitor, 13% more sodium per kilocalorie was consumed by patients prescribed an ACE inhibitor. Prescribed ACE inhibitor independently predicted dietary sodium density (β = 0.238, P = .009).
Sodium intake was higher among patients prescribed ACE inhibitors. Interventions to assist patients with HF with dietary sodium adherence can be informed by assessing medication regimens.
低钠饮食依从性是心力衰竭（HF）自我管理的基础。血管紧张素转换酶（ACE）抑制剂常用于治疗 HF 患者，其可能会改变盐的味觉感知，从而增加钠的摄入量。我们假设，与未开处方 ACE 抑制剂的 HF 患者相比，处方 ACE 抑制剂的 HF 患者的钠摄入量（用膳食钠密度表示）会显著更高。
本研究旨在评估 HF 患者处方 ACE 抑制剂与膳食钠密度之间的关系。
我们对一项观察性纵向研究中 HF 患者的基线数据进行了二次分析。通过将 4 天食物日记中的平均日钠摄入量除以平均消耗的千卡数来计算钠密度。通过查阅病历来确定处方药物。将患者分为处方 ACE 抑制剂和未处方 ACE 抑制剂两类。采用 t 检验比较两组的钠摄入量，采用线性回归检验在控制年龄、性别、纽约心脏协会（NYHA）分级、处方利尿剂和β受体阻滞剂的情况下，处方 ACE 抑制剂是否独立预测钠密度。
共纳入 255 例年龄为 61±12 岁的 HF 患者，其中 67%为男性，44%为 NYHA 分级 III/IV 级，68%处方 ACE 抑制剂。与未处方 ACE 抑制剂的患者相比，处方 ACE 抑制剂的患者每千卡消耗的钠多 13%。处方 ACE 抑制剂独立预测了膳食钠密度（β=0.238，P=0.009）。
处方 ACE 抑制剂的 HF 患者的钠摄入量更高。通过评估药物治疗方案，可以为 HF 患者的饮食钠依从性干预提供信息。
