| Title: | Estimated 24-Hour Urinary Sodium Excretion and Incident Cardiovascular Disease and Mortality Among 398 628 Individuals in UK Biobank |
| Journal: | Hypertension |
| Published: | 6 Jul 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32623924/ |
| DOI: | https://doi.org/10.1161/hypertensionaha.119.14302 |
| URL: | https://www.ahajournals.org/doi/pdf/10.1161/HYPERTENSIONAHA.119.14302 |
Publication 4782
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Abstract
We report on an analysis to explore the association between estimated 24-hour urinary sodium excretion (surrogate for sodium intake) and incident cardiovascular disease (CVD) and mortality. Data were obtained from 398 628 UK Biobank prospective cohort study participants (40-69 years) recruited between 2006 and 2010, with no history of CVD, renal disease, diabetes mellitus or cancer, and cardiovascular events and mortality recorded during follow-up. Hazard ratios between 24-hour sodium excretion were estimated from spot urinary sodium concentrations across incident CVD and its components and all-cause and cause-specific mortality. In restricted cubic splines analyses, there was little evidence for an association between estimated 24-hour sodium excretion and CVD, coronary heart disease, or stroke; hazard ratios for CVD (95% CIs) for the 15th and 85th percentiles (2.5 and 4.2 g/day, respectively) compared with the 50th percentile of estimated sodium excretion (3.2 g/day) were 1.05 (1.01-1.10) and 0.96 (0.92-1.00), respectively. An inverse association was observed with heart failure, but that was no longer apparent in sensitivity analysis. A J-shaped association was observed between estimated sodium excretion and mortality. Our findings do not support a J-shaped association of estimated sodium excretion with CVD, although such an association was apparent for all-cause and cause-specific mortality across a wide range of diseases. Reasons for these differences are unclear; methodological limitations, including the use of estimating equations based on spot urinary data, need to be considered in interpreting our findings.8 Authors
- Paul Elliott
- David C. Muller
- Deborah Schneider-Luftman
- Raha Pazoki
- Evangelos Evangelou
- Abbas Dehghan
- Bruce Neal
- Ioanna Tzoulaki
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