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Is low serum chloride level a risk factor for cardiovascular mortality?
J Cardiovasc Risk 1998; 5(3):177-84JC

Abstract

BACKGROUND

Serum chloride level is routinely assayed in clinical laboratories in the management of patients with kidney disorders and with metabolic diseases. It is a biological parameter that is easily, precisely and relatively cheaply measured. The epidemiological features of serum chloride levels have not been studied before.

METHODS

For the random sample of men and women from the Belgian Interuniversity Research on Nutrition and Health aged 25-74 years, free of symptomatic coronary heart disease at baseline, serum chloride concentrations were measured, among those of other electrolytes. The cohort was followed up for 10 years with respect to subsequent cause-specific mortality.

RESULTS

The results are based on observations of 4793 men and 4313 women. According to Cox regression analysis serum chloride level was one of the strongest predictors of total, cardiovascular disease (CVD) and non-CVD mortalities independently of age, body mass index, sex, smoking, systolic blood pressure, levels of total and high-density lipoprotein cholesterol, uric acid, serum creatinine and serum total proteins and intake of diuretics. This relation was proved to be independent of levels of other serum electrolytes and similar for men and women. The estimated adjusted risk ratio for CVD death for subjects with a serum chloride level < or =100 mmol/l compared with those with levels above that limit was 1.65 (95% confidence interval 1.06-2.57) for men and 2.16 (95% confidence interval 1.11-4.22) for women. The study of adjusted risk ratios for four groups of subjects defined on the basis of their baseline serum chloride levels revealed a decreasing log-linear 'dose-response' relation to total and cardiovascular mortalities.

CONCLUSION

This s the first report from a population-based study to indicate that there is an association between serum chloride level and the incidence of total, CVD and non-CVD mortalities. The risk ratio for CVD mortality associated with a low serum chloride level was comparable to or higher than those observed for well-established CVD risk factors.

Authors+Show Affiliations

Department of Public Health, University of Gent, Belgium. dirk.debacquer@rug.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10201555

Citation

De Bacquer, D, et al. "Is Low Serum Chloride Level a Risk Factor for Cardiovascular Mortality?" Journal of Cardiovascular Risk, vol. 5, no. 3, 1998, pp. 177-84.
De Bacquer D, De Backer G, De Buyzere M, et al. Is low serum chloride level a risk factor for cardiovascular mortality? J Cardiovasc Risk. 1998;5(3):177-84.
De Bacquer, D., De Backer, G., De Buyzere, M., & Kornitzer, M. (1998). Is low serum chloride level a risk factor for cardiovascular mortality? Journal of Cardiovascular Risk, 5(3), pp. 177-84.
De Bacquer D, et al. Is Low Serum Chloride Level a Risk Factor for Cardiovascular Mortality. J Cardiovasc Risk. 1998;5(3):177-84. PubMed PMID: 10201555.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is low serum chloride level a risk factor for cardiovascular mortality? AU - De Bacquer,D, AU - De Backer,G, AU - De Buyzere,M, AU - Kornitzer,M, PY - 1999/4/14/pubmed PY - 1999/4/14/medline PY - 1999/4/14/entrez SP - 177 EP - 84 JF - Journal of cardiovascular risk JO - J Cardiovasc Risk VL - 5 IS - 3 N2 - BACKGROUND: Serum chloride level is routinely assayed in clinical laboratories in the management of patients with kidney disorders and with metabolic diseases. It is a biological parameter that is easily, precisely and relatively cheaply measured. The epidemiological features of serum chloride levels have not been studied before. METHODS: For the random sample of men and women from the Belgian Interuniversity Research on Nutrition and Health aged 25-74 years, free of symptomatic coronary heart disease at baseline, serum chloride concentrations were measured, among those of other electrolytes. The cohort was followed up for 10 years with respect to subsequent cause-specific mortality. RESULTS: The results are based on observations of 4793 men and 4313 women. According to Cox regression analysis serum chloride level was one of the strongest predictors of total, cardiovascular disease (CVD) and non-CVD mortalities independently of age, body mass index, sex, smoking, systolic blood pressure, levels of total and high-density lipoprotein cholesterol, uric acid, serum creatinine and serum total proteins and intake of diuretics. This relation was proved to be independent of levels of other serum electrolytes and similar for men and women. The estimated adjusted risk ratio for CVD death for subjects with a serum chloride level < or =100 mmol/l compared with those with levels above that limit was 1.65 (95% confidence interval 1.06-2.57) for men and 2.16 (95% confidence interval 1.11-4.22) for women. The study of adjusted risk ratios for four groups of subjects defined on the basis of their baseline serum chloride levels revealed a decreasing log-linear 'dose-response' relation to total and cardiovascular mortalities. CONCLUSION: This s the first report from a population-based study to indicate that there is an association between serum chloride level and the incidence of total, CVD and non-CVD mortalities. The risk ratio for CVD mortality associated with a low serum chloride level was comparable to or higher than those observed for well-established CVD risk factors. SN - 1350-6277 UR - https://www.unboundmedicine.com/medline/citation/10201555/Is_low_serum_chloride_level_a_risk_factor_for_cardiovascular_mortality L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10201555.ui DB - PRIME DP - Unbound Medicine ER -