High blood pressure is a risk factor for cardiovascular disease. Increased urinary sodium excretion, representing dietary salt intake, has been linked to higher blood pressure. Perhaps surprising, low sodium intake has been associated with increased risk of death observational studies, but this might be due to the issue that patients with major health issues often consume less salt, either due to poor appetite or as they are following medical advice to reduce salt intake.
To try and work out if salt intake is linked to blood pressure independent of this confounding issue and longer-term outcomes, we used data from over 300,000 UK Biobank participants without pre-existing cardiovascular disease, diabetes or high blood pressure. Overall there was a clear relationship between increasing salt intake and higher blood pressure. During average follow-up of approximately 7 years there were 11932 deaths (1125 cardiovascular deaths) with 10717 nonfatal cardiovascular events. There was no relationship between salt intake and these outcomes. even after more adjustment for existing health conditions.
Therefore, whilst it is clear that higher salt intake is associated with higher blood pressure in healthy people, it is less clear that this is linked to future cardiovascular events. It might be that the follow up was not long enough to see a link, or that salt intake is less clearly linked to mortality and cardiovascular disease than previously thought.
Associations of blood biomarkers with cardiovascular disease and related cardiometabolic outcomes and risk prediction in the clinical setting
In UK Biobank planned blood tests are important in helping detect early signs of groups of related diseases in the heart, blood vessels, brain, as well as early signs of diabetes. We will investigate to what extent these blood tests tell us about how likely someone is to develop these conditions, how these conditions develop, and whether we can intervene. For instance, adding information from these tests might improve our ability to predict the risk of a person having a heart attack. By harnessing the power of genes, we will test whether some of these new markers cause disease. This project will aim to assess avenues to improve health care throughout the population by investigating the improvement of CVD risk scores. More sensitive CVD and related risk scores may lead to better targeting of treatment and a reduction in the burden of CVD in the population. Biomarker measurement in UK biobank has been commenced, and the first tranche of biomarkers to be measured are now known. We will assess whether these markers are associated with, and predict, risk of cardiovascular and metabolic-related conditions. Biomarkers of interest include:
Lipids and lipoproteins (different measures of blood cholesterol), markers of inflammation, markers, of liver function, markers of renal function, sex hormones, markers of glucose control, and markers of bone health. Each of these has plausible biological mechanisms linking them to risk of cardiovascular and metabolic diseases. The full cohort with available data will be explored to maximise generalisability to the whole adult population.
|Professor Naveed Sattar
|University of Glasgow
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