Continue to review the need to restrict salt or fluid. [2018] Advise people with heart failure to avoid salt substitutes that contain The evidence for quality of life was graded very low quality due to risk of bias (selection bias and performance bias), indirectness (indirect population) and imprecision. The evidence for oedema was graded very low quality due to risk of bias (selection bias, performance bias and measurement bias), indirectness (indirect population and outcome) and imprecision. Other comparisons: There was no evidence on any of the following comparisons: Salt restriction programme versus general advice to restrict salt. Salt restriction programme versus no restriction/no advice. Fluid restriction programme versus no restriction/no advice. Trade-off between clinical benefits and harms The committee discussed the evidence for a low sodium programme compared with a moderate sodium programme, which was based on a single small trial. The committee noted that patients median intake of sodium at both baseline and at the end of the study was similar between the 2 groups (at the end of the study, low sodium 1398 mg/day, moderate sodium 1461 mg/day). Notwithstanding the similar reduction in sodium consumption in each group, quality of life in the low sodium group was lower than in the moderate sodium group. This suggested that the restrictive nature of the programme itself, independent of the actual reduction in sodium consumption achieved, had a negative impact on quality of life. There was no clinically important difference in renal function (measured by creatinine) between the low and moderate sodium programmes, which was to be expected given the similarity in the actual sodium levels consumed. The committee also discussed the evidence for a fluid restriction programme compared with general advice to restrict fluid, which again was based on a single small trial. 