Much of what is said about preventing heart disease is focused on diet and exercise. However, not much is said about hydration. But new research from the European Society of Cardiology shows drinking enough water is vitally important in preventing heart failure.

"Our study suggests that maintaining good hydration can prevent or at least slow down the changes within the heart that lead to heart failure," said study author Dr. Natalia Dmitrieva of the National Heart, Lung, and Blood Institute from the National Institutes of Health. "The findings indicate that we need to pay attention to the amount of fluid we consume every day and take action if we find that we drink too little."

It is recommended women drink between 1.6 to 2.1 liters of fluid and men consume between 2 and 3 liters. Surveys show many in the U.S. don’t even meet the recommended minimums, which is believed to be a contributing factor in the high rates of heart disease.

Serum sodium level is used to measure hydration status. When not enough water is consumed the concentration increases. When that happens, the body attempts to conserve water which activates bodily processes that contribute to heart failure.

"It is natural to think that hydration and serum sodium should change day to day depending on how much we drink on each day," Dr. Dmitrieva said. "However, serum sodium concentration remains within a narrow range over long periods, which is likely related to habitual fluid consumption."

The study consisted of nearly 16,000 adults from the Atherosclerosis Risk in Communities (ARIC) cohort. They ranged in age between 44 and 66. The purpose was to see whether hydration habits in middle age can be used as a predictor of the development of heart disease years later. Scientists also examined the connection between hydration and the thickening of the heart’s left ventricle (left ventricle hypertrophy), which is a forerunner to a heart failure diagnosis.

The participants were divided into four groups based on their serum sodium concentration from their initial measurements. They were then periodically checked over the span of 25 years.

Researchers found a higher serum sodium concentration at the outset was associated with higher rates of both heart failure and left ventricle hypertrophy 25 years later. The results held true even when factoring for things such as blood pressure, kidney function, cholesterol, BMI and smoking.

Scientists found every 1 mmol/l increase in serum sodium concentration at the outset translated to 1.11 and 1.20 greater odds of developing heart failure and left ventricular hypertrophy, respectively.

"The results suggest that good hydration throughout life may decrease the risk of developing left ventricular hypertrophy and heart failure," Dr. Dmitrieva said. "In addition, our finding that serum sodium exceeding 142mmol/l increases the risk of adverse effects in the heart may help to identify people who could benefit from an evaluation of their hydration level. This sodium level is within the normal range and would not be labelled as abnormal in lab test results but could be used by physicians during regular physical exams to identify people whose usual fluid intake should be assessed."

Click here to read more at the European Society of Cardiology.