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The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease
BACKGROUND: Most evidence on the relationship between sodium and potassium intake and cardiovascular disease originated from general population studies. This study aimed to evaluate the relation between estimated 24-hour sodium and potassium urinary excretion and the risk of recurrent vascular event...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929575/ https://www.ncbi.nlm.nih.gov/pubmed/35298524 http://dx.doi.org/10.1371/journal.pone.0265429 |
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author | Groenland, Eline H. Vendeville, Jean-Paul Bots, Michiel L. de Borst, Gert Jan Nathoe, Hendrik M. Ruigrok, Ynte M. Blankestijn, Peter J. Visseren, Frank L. J. Spiering, Wilko |
author_facet | Groenland, Eline H. Vendeville, Jean-Paul Bots, Michiel L. de Borst, Gert Jan Nathoe, Hendrik M. Ruigrok, Ynte M. Blankestijn, Peter J. Visseren, Frank L. J. Spiering, Wilko |
author_sort | Groenland, Eline H. |
collection | PubMed |
description | BACKGROUND: Most evidence on the relationship between sodium and potassium intake and cardiovascular disease originated from general population studies. This study aimed to evaluate the relation between estimated 24-hour sodium and potassium urinary excretion and the risk of recurrent vascular events and mortality in patients with vascular disease. METHODS: 7561 patients with vascular disease enrolled in the UCC-SMART cohort (1996–2015) were included. Twenty-four hour sodium and potassium urinary excretion were estimated (Kawasaki formulae) from morning urine samples. Cox proportional hazard models with restricted cubic splines were used to evaluate the relation between estimated urinary salt excretion and major adverse cardiovascular events (MACE; including myocardial infarction, stroke, cardiovascular mortality) and all-cause mortality. RESULTS: After a median follow-up of 7.4 years (interquartile range: 4.1–11.0), the relations between estimated 24-hour sodium urinary excretion and outcomes were J-shaped with nadirs of 4.59 gram/day for recurrent MACE and 4.97 gram/day for all-cause mortality. The relation between sodium-to-potassium excretion ratio and outcomes were also J-shaped with nadirs of 2.71 for recurrent MACE and 2.60 for all-cause mortality. Higher potassium urinary excretion was related to an increased risk of both recurrent MACE (HR 1.25 per gram potassium excretion per day; 95%CI 1.13–1.39) and all cause-mortality (HR 1.13 per gram potassium excretion per day; 95%CI 1.03–1.25). CONCLUSIONS: In patients with established vascular disease, lower and higher sodium intake were associated with higher risk of recurrent MACE and all-cause mortality. Higher estimated 24-hour potassium urinary excretion was associated with a higher risk of recurrent MACE and all-cause mortality. |
format | Online Article Text |
id | pubmed-8929575 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-89295752022-03-18 The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease Groenland, Eline H. Vendeville, Jean-Paul Bots, Michiel L. de Borst, Gert Jan Nathoe, Hendrik M. Ruigrok, Ynte M. Blankestijn, Peter J. Visseren, Frank L. J. Spiering, Wilko PLoS One Research Article BACKGROUND: Most evidence on the relationship between sodium and potassium intake and cardiovascular disease originated from general population studies. This study aimed to evaluate the relation between estimated 24-hour sodium and potassium urinary excretion and the risk of recurrent vascular events and mortality in patients with vascular disease. METHODS: 7561 patients with vascular disease enrolled in the UCC-SMART cohort (1996–2015) were included. Twenty-four hour sodium and potassium urinary excretion were estimated (Kawasaki formulae) from morning urine samples. Cox proportional hazard models with restricted cubic splines were used to evaluate the relation between estimated urinary salt excretion and major adverse cardiovascular events (MACE; including myocardial infarction, stroke, cardiovascular mortality) and all-cause mortality. RESULTS: After a median follow-up of 7.4 years (interquartile range: 4.1–11.0), the relations between estimated 24-hour sodium urinary excretion and outcomes were J-shaped with nadirs of 4.59 gram/day for recurrent MACE and 4.97 gram/day for all-cause mortality. The relation between sodium-to-potassium excretion ratio and outcomes were also J-shaped with nadirs of 2.71 for recurrent MACE and 2.60 for all-cause mortality. Higher potassium urinary excretion was related to an increased risk of both recurrent MACE (HR 1.25 per gram potassium excretion per day; 95%CI 1.13–1.39) and all cause-mortality (HR 1.13 per gram potassium excretion per day; 95%CI 1.03–1.25). CONCLUSIONS: In patients with established vascular disease, lower and higher sodium intake were associated with higher risk of recurrent MACE and all-cause mortality. Higher estimated 24-hour potassium urinary excretion was associated with a higher risk of recurrent MACE and all-cause mortality. Public Library of Science 2022-03-17 /pmc/articles/PMC8929575/ /pubmed/35298524 http://dx.doi.org/10.1371/journal.pone.0265429 Text en © 2022 Groenland et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Groenland, Eline H. Vendeville, Jean-Paul Bots, Michiel L. de Borst, Gert Jan Nathoe, Hendrik M. Ruigrok, Ynte M. Blankestijn, Peter J. Visseren, Frank L. J. Spiering, Wilko The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
title | The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
title_full | The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
title_fullStr | The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
title_full_unstemmed | The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
title_short | The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
title_sort | relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929575/ https://www.ncbi.nlm.nih.gov/pubmed/35298524 http://dx.doi.org/10.1371/journal.pone.0265429 |
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