18663 Ventura Blvd, Suite 202, Tarzana CA 91356

Sunday, January 16, 2011


Sodium.  Salt.  It's the bane of my existence as a cardiologist.

In medical school, we learn that 85% of diagnosis is history.  This is very true, especially when it comes to uncontrolled hypertension or congestive heart failure.

Why does sodium matter?  Sodium consumption leads to retention of fluid.  This can raise the blood pressure, and in someone with a weak or stiff heart, can lead to congestive heart failure.

When I encounter a patient with an extremely elevated blood pressure or new onset heart failure, the first thing I ask about is diet.

Me:  Do you watch your salt intake?
Patient:  Yes, I never add salt to my food.

And there is the first fallacy:  Just because you are not salting your food does not mean you are consuming a low-sodium diet.  There is often plenty of sodium in the food you are eating.

Me:  What did you eat yesterday?

The answers to this question are always interesting.  Here are some of the recent high-sodium items consumed by patients of mine:
Soup "but it was homemade soup, not from a can"
Pad Thai "with just a quarter of a cup of fish sauce"
Hot dogs
In 'N Out Burger
Various foods on a cruise ship
Las Vegas buffet

If you are eating at a restaurant, you can assume you're getting a ton of sodium.  Any soups, or entrees labled au jus, in broth, marinated, in soy sauce, these will all be highest in sodium.  Or, if it comes from a box or a can at the grocery store, be cautious and read the label.  And finally, any homemade broth from an animal is loaded with sodium -- the drippings of the animal are very concentrated in sodium.

Read here for more on diet and hypertension and heart failure.
Image from


Ruth said...

I've kept my blood pressure in the normal range by exercise and a low salt diet. I recently went on a cruise and emailed passenger services if I could have a low salt diet while on board. They replied yes, and greeted my discretely at our first dinner. Each night they gave me the next day's menu, had me select my items, and cooked them separately for me! I could tell they had really done this, as I truly eat a low salt diet and become very thirsty when I eat more salt than normal. I'm also very sensitive to the taste salt as I don't use it. I hadn't really thought a cruise ship would do this, and had an opportunity to meet the head chef and thank him and he was extremely gracious. And, we had booked this as a bargain trip--$115 for the whole week! (Inside cabin, forward, but still....) So, it always pays to ask for accomodation!

Mama Pea said...

I just found your blog tonight trying to find more info to convince ny father to go vegan. He has heart disease and had his second cardioversion today for AF. I am vegan and have been fo several years. I have a fun, vegan family blog & a cookbook coming out this summer, but yet I haven't convinced those closest to me that this diet can save their lives. I'll be back to gather evidence & I'd invite you to come gather recipes :)

Sonam Sen said...


In today’s modern world, changing lifestyles are leading to increase in the number of diseases related to the heart. With that, many techniques of surgery for the heart have come up. Of all the available options for surgery, Angioplasty has proved to be one of the safest ways.

Angioplasty was first used in the late 70’s. It involves the widening of an obstructed blood artery, which has happened because of atherosclerosis, by mechanical means. A balloon catheter, which is an empty one and is collapsed, is taken and it is passed through the location where the surgery is to be done. Then the catheter is inflated by pressure which is around 200 times compared to that of the blood pressure.

The inflated balloon has sufficient pressure in it to crush most of the fatty deposits on the sides of the artery walls. Thus, the artery opens up properly and the flow becomes proper and the obstruction is now minimal. After this is done, the catheter is collapsed and made empty and is finally withdrawn.

Angioplasty is of several types based on the location of the arteries which have been blocked. Some of these are Renal, Cerebral, Coronary, etc.

Once Angioplasty is done, the patient is kept under observation for a day or two. The blood pressure is monitored continuously along with the heart beat rate. Proper medications are given if necessary.

Since the time from which it has been put to use, Angioplasty has helped lot of patients and has saved their life. The best outcome of it is the prevention of heart attacks and bypass surgeries.

Anonymous said...

OTOH, there are people with autonomic issues who need plenty of sodium, in order to remain upright. So this is not a one-size-fits-all sort of thing.

Administrator said...

I was diagnosed with idiopathic cardiomyopathy a few years ago and had to switch to a salt restricted diet. It was hard at first. However, after about a month you start tasting the real food. Like you say, it's amazing how much salt is in everyday food.

Now when I go out to a restaurant, I ask if the food can be salt free. They are always very accommodating and now after 4 years, I don't even notice what I'm missing.

However, if I do get some salty french fries (for example), the salt is overwhelming and I find myself scraping off the salt with a napkin before I can eat them.

Bread is notorious for having a lot of salt in it, so now I limit the amount of bread I eat, to keep my daily intake to a manageable level.