Dr's Casebook: Drink plenty of water and reduce salt to protect your heart

Dr Keith Souter writes: Apart from the obvious matter of regular runs and trying to keep my stamina up I am focusing on two things.

Firstly, reducing my salt intake. As a Scotsman I have always taken salt on my morning porridge, but over the last few months have successfully substituted it with a teaspoon of cinnamon.

Secondly, I aim to drink plenty of water. The fact is that you actually need water long before you feel thirsty. The problem is that when you are deprived of water, your cells wilt, just like a plant.

Recent research just published in the European Heart Journal indicates that staying hydrated throughout life is important and it can in fact prevent people from developing heart failure in later life.

Essentially, heart failure means that the heart is not pumping enough blood around the body to the organs and tissues at the right pressure.

As a result, fluid accumulates in the lungs to cause breathlessness, the ankles may start to swell and the person generally feels fatigued.

It affects a fifth of the over-70s.

We know that serum sodium is a precise measure of hydration status. Quite simply, when people drink less fluid, the concentration of serum sodium increases.

The body then attempts to conserve water, and if these processes are maintained they will eventually contribute to the development of heart failure.

In this study 16,000 men in the Atherosclerosis Risk in Communities (ARIC) study were followed up for 25 years with check-ups every five years.

Participants were aged 44 to 66 years on entry. They were divided into four groups depending on increasing levels of sodium.

They found a highly significant association between the sodium levels and the hydration level throughout middle life with both heart failure and left ventricular hypertrophy 25 years later.

The researchers recommended a daily fluid intake of six to eight cups (1.5 to two litres) for women and eight to 12 cups (two to three litres) for men.

So, keeping your salt intake down, since the main source of sodium is your salt intake and making sure you drink the recommended fluid level every day should reduce your risk of heart failure late on in life.