Study finds Ramadan fasting to be safe for patients with heart failure

Researchers have revealed that Ramadan fasting is safe for patients with heart failure based on a prospective observational study wherein they examined the effect of Ramadan fasting on symptoms of patients with chronic heart failure and reduced ejection fraction.

The study included 249 outpatients from three heart failure clinics who had planned to fast during Ramadan in 2017. A total of 227 (91%) patients fasted for the duration of Ramadan. Of those, 209 (92%) had no changes or improved symptoms, while symptoms worsened in 18 (8%) patients. The study found that patients with worsening symptoms were less likely to have adhered to fluid and salt restrictions.

More than one billion Muslims worldwide abstain from food, drink, and oral medications from dawn to sunset during the holy month of Ramadan. Patients with chronic illnesses are exempt but most elect to fast. The fasting period typically lasts 15 to 16 hours, and two meals are eaten during the night.

Symptoms of heart failure include shortness of breath, ankle swelling, and fatigue. Patients are advised to limit daily intake of fluid to less than two litres and sodium to less than 2500 mg. Medications include angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers, diuretics and digoxin.

According to one of the authors, patients who don’t follow the fluid and salt recommendations during Ramadan report that it is because of the increase in socialising. When they visit friends the food has a normal or high salt content, and they drink a lot of fluids within a short period time, which can cause fluid shifts in the body.

The study excluded patients with an ejection fraction of 40% or more, recently diagnosed patients (less than three months), and patients with advanced heart failure (two emergency visits in the past three months, or three visits in the past six months). The results do not apply to these groups.

Steven Anderson

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