While healthcare professionals should not routinely advise patients to restrict salt or fluid, there may be specific clinical circumstances where restriction is appropriate. For example, both salt and fluid restriction may be beneficial in very severe or advanced heart failure (though should be used very carefully in older patients), and fluid restriction may be beneficial for hyponatremia. In addition, for patients consuming large quantities of sodium or fluid, reduction to normal levels of consumption may be beneficial (especially for hypertensive patients consuming a large amount of salt). Healthcare professionals should ask their patients about their levels of salt and fluid consumption in order to provide appropriate advice, and this should not be open-ended, but there should be opportunities to review whether the strategy was effective for the individual. The committee recognised the uncertainty in the evidence and the possibility Chronic Heart Failure Beta-blockers in heart failure and concomitant atrial fibrillation NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Recommendations Do not routinely advise people with heart failure to restrict their sodium or fluid consumption. Ask about salt and fluid consumption and, if needed, advise as follows: restricting fluids for people with dilutional hyponatraemia reducing intake for people with high levels of salt and/or fluid consumption. Continue to review the need to restrict salt or fluid. [2018] Advise people with heart failure to avoid salt substitutes that contain that future research may conclude that salt and/or fluid restriction is beneficial. In particular, the large RCT currently underway comparing a low sodium diet versus usual care (general advice to limit salt) (SODIUM-HF346 ). 