Good hydration can reduce the long-term risks of heart failure

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Serum sodium levels can help identify adults who are more likely to suffer from heart disease.

Staying well hydrated may be associated with a reduced risk of developing heart failure, according to researchers from the National Institutes of Health. Their results, which appear in the European Heart Journal, suggest that consuming sufficient amounts of fluids throughout life not only supports essential body functioning, but can also reduce the risk of serious heart problems in the future.

Heart failure, a chronic condition that develops when the heart does not pump enough blood for the body’s needs, affects more than 6.2 million Americans, just over 2% of the population. It is also more common among adults aged 65 and over.

“Similar to reducing salt intake, drinking enough water and staying hydrated are ways to support our hearts and can help reduce long-term risks for heart disease,” said Natalia Dmitrieva, Ph.D., author. principal of the study and researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH.

After conducting preclinical research suggesting connections between dehydration and cardiac fibrosis, a hardening of the heart muscles, Dmitrieva and researchers looked for similar associations in large-scale population studies. To begin, they analyzed data from more than 15,000 adults, aged 45 to 66, who enrolled in the Atherosclerosis Risk in Communities (ARIC) study between 1987 and 1989 and shared information from doctor visits for a period of 25 years.

In selecting participants for their retrospective review, the scientists focused on those whose hydration levels were within a normal range and who did not have diabetes, obesity, or heart failure at the start of the study. About 11,814 adults were included in the final analysis, and of these, the researchers found that 1,366 (11.56%) subsequently developed heart failure.

To assess potential hydration links, the team assessed the participants’ hydration status using several clinical measures. Observing serum sodium levels, which increases as fluid levels in the body decrease, was particularly helpful in helping to identify participants with an increased risk of developing heart failure. It also helped identify older adults with an increased risk of developing both heart failure and left ventricular hypertrophy, an enlarged and thickened heart.

For example, adults with serum sodium levels as low as 143 milliequivalents per liter (mEq / L) – a normal range is 135-146 mEq / L – in middle age had an associated 39% higher risk of developing heart failure than to adults with lower levels. And for every 1 mEq / L increase in serum sodium within the normal range of 135-146 mEq / L, the likelihood of a participant developing heart failure is increased by 5%.

In a cohort of approximately 5,000 adults aged 70 to 90 years, those with serum sodium levels of 142.5-143 mEq / L at middle age were 62% more likely to develop left ventricular hypertrophy. Serum sodium levels starting at 143 mEq / L were correlated with a 102% increased risk of left ventricular hypertrophy and a 54% increased risk of heart failure.

Based on these data, the authors conclude that serum sodium levels above 142 mEq / L in middle age are associated with increased risks of developing left ventricular hypertrophy and heart failure later in life.

A randomized, controlled trial will be needed to confirm these preliminary results, the researchers said. However, these early associations suggest that good hydration can help prevent or slow the progression of changes within the heart that can lead to heart failure.

“Serum sodium and fluid intake can be easily assessed in clinical exams and help clinicians identify patients who can benefit from learning ways to stay hydrated,” said Manfred Boehm, MD, who leads the Laboratory. of cardiovascular regenerative medicine.

Fluids are essential for a number of bodily functions, including helping the heart pump blood efficiently, supporting blood vessel function, and orchestrating circulation. Yet many people take far less than they need, the researchers said. While fluid guidelines vary based on the body’s needs, researchers have recommended a daily fluid intake of 6-8 cups (1.5-2.1 liters) for women and 8-12 cups (2- 3 liters) for men. The Centers for Disease Control and Prevention also provide tips to support healthy hydration.

Reference: “Middle-aged serum sodium levels in the upper normal range and risk of heart failure” by Natalia I. Dmitrieva, Delong Liu, Colin O. Wu and Manfred Boehm, March 29, 2022, European Journal of the Heart.
DOI: 10.1093 / eurheartj / ehac138

This research was supported by the Intramural Research Division at NHLBI. Other co-authors include Delong Liu, Ph.D., of the Laboratory of Vascular and Matrix Genetics and Colin O. Wu, Ph.D., of the Office of Biostatistics Research. The ARIC study was supported by research contracts from the NHLBI, NIH, and the Department of Health and Human Services.

Information on the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research into heart, lung and blood disease and sleep disorders that improve scientific knowledge, improve public health and save lives.

Information on the National Institutes of Health (NIH): NIH, the nation’s medical research agency, comprises 27 institutes and centers and is a component of the United States Department of Health and Human Services. NIH is the leading federal agency that conducts and supports basic, clinical and translational medical research and is studying the causes, treatments, and cures for common and rare diseases.

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