Projected Salt Removal and Dangers of Dying and you can Cardio Occurrences

To further explore the potential effect of imbalanced confounders, we performed propensity-score–matched sensitivity analyses 30 that compared a high estimated sodium excretion (?6.00 g per day) with a moderate level (3.00 to 5.99 g per day) and that compared a low estimated sodium excretion (<3.00 g per day) with the moderate level. In a secondary analysis, we examined the association between an estimated “usual” level of sodium or potassium excretion and death and cardiovascular disease, with correction for regression dilution bias (with the use of repeated measurements in 448 participants). 31 All analyses were conducted with the use of SAS software, version 9.2, for the UNIX operating system (SAS Institute).

Data Users and Outcomes

The study included 101,945 participants, 42% of whom were from China. The mean estimated 24-hour sodium excretion was 4.93 g, and the mean estimated 24-hour potassium excretion was 2.12 g ( Table 1 , and Table S1 in the Supplementary Appendix). The mean systolic and diastolic blood pressures were higher among participants with a higher estimated sodium excretion (P<0.001). The mean duration of follow-up was 3.7 years, with follow-up completed for 95% of the participants. The primary composite outcome of death or a major cardiovascular event occurred in 3317 participants (3.3%): 1976 participants died (650 from cardiovascular causes), 857 had myocardial infarction, 872 had stroke, and 261 had heart failure. Participants may have had more than one cardiovascular event.

Panel A reports a restricted-cubic-spline plot of your relationship between projected twenty-four-hour urinary salt excretion and also the ingredient result of dying from any cause and you may biggest aerobic events. The latest spline bend is truncated during the g on a daily basis (event speed among players which have salt excretion > g just about every day, 8 events in 305 professionals). Committee B suggests a small-cubic-spline plot of the association ranging from projected salt excretion and you will demise. The event speed among players that have sodium removal in excess of grams on a daily basis was 5 occurrences into the 305 players. Panel C suggests a restricted-cubic-spline area of one’s connection ranging from projected sodium removal and you may major cardiovascular incidents (recognized as passing away from aerobic factors, myocardial infarction, heart attack, otherwise cardiovascular system failure). The big event rates certainly users that have sodium removal of more than grams everyday is actually 6 events in 305 professionals. Every plots was in fact modified for age, gender, geographical area, instructional level, origins (Far eastern versus. non-Asian), alcohol consumption, body-mass index, and you may status with regards to diabetic issues mellitus, reputation for cardio situations, and newest puffing. Dashed outlines indicate 95% count on durations. The brand new median sodium removal (cuatro.72 g daily) are the new reference basic, expressed because of the yellow range. To alter the values for projected sodium excretion to help you sodium intake within the g per day, proliferate by the 2.5.


As compared with an estimated salt removal out-of cuatro.00 to 5.99 g per day (brand new site category), projected excretion of seven.00 grams a-day or maybe more is in the enhanced threats of the primary element lead (possibility proportion, 1.15; 95% count on period [CI], step one.02 to a single.30), death from people lead to (potential proportion, step one.25; 95% CI, step 1.07 to just one.48), a major cardio enjoy (possibility proportion, step one.16; 95% CI, step 1.01 to 1.34), escort babylon Glendale CA dying of cardio grounds (opportunity proportion, 1.54; 95% CI, step 1.21 to 1.95), and coronary arrest causing death or hospitalization (chance proportion, step one.29; 95% CI, step one.02 to 1.63) to your multivariable analysis ( Dining table dos and you may Contour 1 , and you can Dining table S2 on the Secondary Appendix). The latest relationship ranging from a leading projected salt removal (?eight.00 grams daily) and also the first mixture benefit, significant aerobic events, and stroke ultimately causing death or hospitalization is actually attenuated and you may try not significant immediately following adjustment to possess blood pressure level otherwise earlier in the day analysis of blood pressure however, remained tall to have demise of people end up in ( Table dos , and you will Desk S2 on the Secondary Appendix).