Changing the Game: Re-examining the Relationship between salt and heart failure

February is Heart Month at the Mazankowski Alberta Heart Institute.

Dr. Justin Ezekowitz, a cardiologist at the Mazankowski Alberta Heart Institute and co-director of the Canadian VIGOUR Centre, has a question about salt – is it good or bad for cardiac patients with heart failure?

“It’s important for us to know, for our patients’ benefit, whether a higher salt diet or a lower salt diet is better,” says Dr. Ezekowitz (pictured below, left). “While you and I may want to have lower salt in our diet, the effects are different for patients with life-threatening heart disease. Bodies respond differently to salt when disease is present – so maybe a high or lower salt is better.”

Two years after the University Hospital Foundation initially spoke with Dr. Ezekowitz about his SODIUM-HF trial, his team is about to reach the halfway point on patient enrollment in the study. And those patients are not only from Alberta, or even Canada – but reflect global interest.

“The funding we received from the University Hospital Foundation has allowed us to expand the number of our sites – so we now have a multinational trial. We have centres set up here, as well as places like Mexico, Columbia, Chile, New Zealand and Australia,” explains Dr. Ezekowitz.

The global reach of the research means that the researchers are capturing the necessary data to turn their findings into clinical care quicker.

“Our focus is on getting it done right, rather than faster.”

“Once the trial is done, we will have immediate translation into clinical care. And that’s because we’ve tried to approach this pragmatically – the patients in the study are still doing their own shopping and cooking; however, they are also seeing dieticians and having their blood pressure checked.”

While this research could mean big things for heart failure patients – and is absolutely necessary, Dr. Ezekowitz tells us, as a clinical trial examining sodium and heart failure has never been done on this scale before – Dr. Ezekowitz stresses that higher salt might be better for heart failure patients, but not the general public.

“Regardless of outcome, there will be immediate clinical implications in medicine. The day after it’s published this could have an impact on policy, and how policy makers choose to allocate resources.”

Dr. Ezekowitz is the lead researcher in the SODIUM-HF Trial. After receiving seed funding from the University Hospital Foundation’s Medical Research Competition in 2011 (in the amount of $35,000 to support an initial pilot project with about 30 patients), Dr. Ezekowitz and his team have leveraged further funding from the Canadian Institutes of Health Research and an additional $200,000 from the University Hospital Foundation, which has enabled the trial to expand globally – including research centres in Chile, Mexico, Australia and New Zealand.

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