Heart Failure (HF) is a major public health problem resulting in high rates of hospitalization and mortality. Current HF guidelines recommend sodium-restricted dietary approaches to prevent acute HF, but adherence to salt restriction may be hampered by patients’ perceived burden, as measured by the recently validated Burden scale In Restricted Diets questionnaire (BIRD).

To assess sodium diet prescription patterns by cardiologists and evaluate their relationship with actual understanding, adherence and self-rated burden in HF patients.

Enrolment of 3000 patients at the national level is planned for the OFICsel observatory, through a representative panel of 300 cardiologists including out and inpatients. Data collection included clinical, biological, echocardiography and treatment/diet characteristics [physician] and socio-demographics, understanding, adherence and perceived burden (BIRD) related to restricted diets.

As of May 1st 2017, data from 1438 patients from 79 French departments (mean age 66.8 years±13.9 standard deviation; 71% men). Fifty-nine percent patients were hospitalized, 7% in rehabilitation center and 34% outpatients. LVEF, NYHA class II/III and ischemic cardiopathy rates were respectively: 38.8±14.0, 51%/28% and 44%. Eighty-six percent had HF for more than 3 months and 27% were in acute heart failure. Physician salt regimen prescriptions among <3g/day, 4–6g/d, 6g/d, >6g/d, unknown were 10%, 33%, 41%, 11%, 5% while recommendations understood by patients were 21%, 27%, 22%, 22%, 8%, respectively. Overall agreement was only 42% with a low concordance kappa of 0.25. Increasing burden was associated with increasingly stringent salt diets (Fig. 1; P<0.001).

Substantial discrepancies were found between salt restricted diets prescribed and those understood by HF patients. Further analyses of the ongoing OFICsel observatory will identify predictors of non-adherence.