Lower Urinary Sodium, Higher Potassium Tied to Lower CV Risk!
Higher dietary sodium intake, estimated by determining daily excretion from at least two 24-hour urine samples, was associated with an increased risk for a cardiovascular event in a meta-analysis of six cohorts. And higher potassium intake, determined the same way, was associated with a decreased risk for a cardiovascular event, including coronary revascularization, fatal or nonfatal myocardial infarction, and fatal or nonfatal stroke, over 8.8 years among more than 10,000 healthy participants. Those in the highest quartile for 24-hour sodium excretion had a 60% higher risk for a CV event than those in the lowest quartile (hazard ratios [HR], 1.60; 95% CI, 1.19 - 2.14). At the same time, participants with the highest 24-hour potassium excretion had a 31% lower risk for a CV event than those with the lowest excretion (HR, 0.69; 95% CI, 0.51 - 0.91).
@deepjoy-0 Overall, this is a well-conducted study that adds to the literature regarding sodium intake (using 24-h urine sodium collections as a surrogate) and CV outcomes. It did not identify a J-shaped curve, with low urine sodium excretion being associated with higher CV events, which has been described previously in studies with questionable methodology regarding assessment of sodium intake. It adds to the findings of the TOHP studies, which also failed to show increased risk for CV events at lower levels of sodium intake using 24-h urine collections, said Arora, clinical assistant professor, Department of Nephrology, University of Washington, Seattle. Study limitations, he added, include the inherent limitations of observational studies, and it was in mainly generally healthy White individuals so it is not generalizable to other populations, which the researchers also acknowledge. In addition, although there was a dose-response reduction in CV events with reduction in sodium intake in a spline plot of the association, only the difference between quartile 4 (mean daily sodium excretion of 4692 mg) and quartile 1 (2212 mg) was significant; this was also true for potassium.