{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T10:47:55Z","timestamp":1769078875084,"version":"3.49.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":510,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005630","name":"Soci\u00e9t\u00e9 Fran\u00e7aise de Cardiologie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005630","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Heart Failure and Cardiomyopathy Group"},{"DOI":"10.13039\/501100005630","name":"Soci\u00e9t\u00e9 Fran\u00e7aise de Cardiologie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005630","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Reducing sodium intake is necessary for patients with chronic heart failure (CHF). Salt substitutes (saltSubs) have become increasingly popular as recommendations by healthcare professionals (HCPs) as well as options for patients and their caregivers. However, their consumption is generally potassium based and remains poorly evaluated in CHF management. Their impact on guideline-directed medical therapies (GDMTs) also remains unknown. The primary objective of this study was to provide a description and estimate of HCP recommendations and reported use of saltSubs in France. Secondary objectives were to identify if there was an association between these recommendations by HCPs and the use of GDMTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A nationwide, questionnaire-based, cross-sectional, epidemiological study was conducted from September 2020 to July 2021. Data collection included baseline characteristics, the use and recommendations of saltSubs, and the use of GDMTs, which included (i) angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) or angiotensin receptor\u2013neprilysin inhibitors (ARNis), (ii) mineralocorticoid receptor antagonists (MRAs), and\/or (iii) beta-blockers (BBs). In total, 13% of HCPs advised saltSubs and 17% of patients and 22% of caregivers reported their consumption. CHF patients advised to take saltSubs did not differ in terms of left ventricular ejection fraction (EF) &amp;lt;40%, ischaemic origin, and New York Heart Association III\u2013IV class, but were more recently hospitalized for acute HF (P = 0.004). HCPs who recommended saltSubs to patients were more likely to advise an anti-diabetic diet (P &amp;lt; 0.001), cholesterol-lowering diet (P &amp;lt; 0.001), and exercise (P = 0.018). In the overall population, ACEi\/ARB\/ARNi use was less frequent in case of saltSub recommendations (74% vs. 82%, P = 0.012). The concomitant prescription of none, one, two, or three GDMTs was less favourable in case of saltSub recommendations (P = 0.046). There was no significant difference for the presence of MRA (56% vs. 58%) and\/or BB (78% vs. 82%). The under-prescription of ACEi\/ARB\/ARNi was found when patients had EF &amp;lt; 40% (P = 0.029) and\/or EF \u2265 40% (P = 0.043). In the subgroup with left ventricular EF \u2265 40%, we found a higher thiazide use (P = 0.014) and a less frequent use of low EF GDMTs (P = 0.044) in case of being recommended saltSubs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Beyond the well-established risk for hyperkalaemia, our preliminary results suggest a potentially negative impact of saltSubs on GDMT use, especially for ACEis\/ARBs\/ARNis in CHF management. saltSub recommendations and their availability from open sale outlets should be considered to avoid possible misuse or deference from GDMTs in the future. Informed advice to consumers should also be considered from HCPs or pharmacists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14706","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:43:15Z","timestamp":1716511395000},"page":"2455-2459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Salt Substitute Recommendations for Heart Failure Patients May Influence Guideline-Directed Medical Therapies Titration"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9360-5302","authenticated-orcid":false,"given":"Jean-Michel","family":"Tarti\u00e8re","sequence":"first","affiliation":[{"name":"H\u00f4pital Sainte Musse, CHITS , Toulon ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Roubille","sequence":"additional","affiliation":[{"name":"University of Montpellier, INSERM, CNRS, CHU de Montpellier , Montpellier ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muriel","family":"Salvat","sequence":"additional","affiliation":[{"name":"Grenoble Alpes University Hospital , La Tronche ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thibaud","family":"Damy","sequence":"additional","affiliation":[{"name":"Hospital Henri Mondor, AP-HP , Cr\u00e9teil ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Beauvais","sequence":"additional","affiliation":[{"name":"Hospital Lariboisi\u00e8re, AP-HP , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Berthelot","sequence":"additional","affiliation":[{"name":"Hospital Bicetre, AP-HP , Le Kremlin-Bic\u00eatre ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Lamblin","sequence":"additional","affiliation":[{"name":"Pasteur Institute of Lille , Lille ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lamia","family":"Kesri-Tarti\u00e8re","sequence":"additional","affiliation":[{"name":"H\u00f4pital Sainte Musse, CHITS , Toulon ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"2026012113132278400_ehf214706-bib-0001","doi-asserted-by":"publisher","first-page":"9474","DOI":"10.3390\/ijms21249474","article-title":"Sodium intake and heart failure","volume":"21","author":"Patel","year":"2020","journal-title":"Int J Mol Sci"},{"key":"2026012113132278400_ehf214706-bib-0002","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/ejhf.2333","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC). 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