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Sodium intake and mortality in the NHANES II follow-up study.
Am J Med. 2006 Mar; 119(3):275.e7-14.AJ

Abstract

PURPOSE

US Dietary Guidelines recommend a daily sodium intake <2300 mg, but evidence linking sodium intake to mortality outcomes is scant and inconsistent. To assess the association of sodium intake with cardiovascular disease (CVD) and all-cause mortality and the potential impact of dietary sodium intake <2300 mg, we examined data from the Second National Health and Nutrition Examination Survey (NHANES II).

METHODS

Observational cohort study linking sodium, estimated by single 24-hour dietary recall and adjusted for calorie intake, in a community sample (n = 7154) representing 78.9 million non-institutionalized US adults (ages 30-74). Hazard ratios (HR) for CVD and all-cause mortality were calculated from multivariable adjusted Cox models accounting for the sampling design.

RESULTS

Over mean 13.7 (range: 0.5-16.8) years follow-up, there were 1343 deaths (541 CVD). Sodium (adjusted for calories) and sodium/calorie ratio as continuous variables had independent inverse associations with CVD mortality (P = .03 and P = .008, respectively). Adjusted HR of CVD mortality for sodium <2300 mg was 1.37 (95% confidence interval [CI]: 1.03-1.81, P = .033), and 1.28 (95% CI: 1.10-1.50, P = .003) for all-cause mortality. Alternate sodium thresholds from 1900-2700 mg gave similar results. Results were consistent in the majority of subgroups examined, but no such associations were observed for those <55 years old, non-whites, or the obese.

CONCLUSION

The inverse association of sodium to CVD mortality seen here raises questions regarding the likelihood of a survival advantage accompanying a lower sodium diet. These findings highlight the need for further study of the relation of dietary sodium to mortality outcomes.

Authors+Show Affiliations

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. hicohen@aecom.yu.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16490476

Citation

Cohen, Hillel W., et al. "Sodium Intake and Mortality in the NHANES II Follow-up Study." The American Journal of Medicine, vol. 119, no. 3, 2006, pp. 275.e7-14.
Cohen HW, Hailpern SM, Fang J, et al. Sodium intake and mortality in the NHANES II follow-up study. Am J Med. 2006;119(3):275.e7-14.
Cohen, H. W., Hailpern, S. M., Fang, J., & Alderman, M. H. (2006). Sodium intake and mortality in the NHANES II follow-up study. The American Journal of Medicine, 119(3), e7-14.
Cohen HW, et al. Sodium Intake and Mortality in the NHANES II Follow-up Study. Am J Med. 2006;119(3):275.e7-14. PubMed PMID: 16490476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sodium intake and mortality in the NHANES II follow-up study. AU - Cohen,Hillel W, AU - Hailpern,Susan M, AU - Fang,Jing, AU - Alderman,Michael H, PY - 2005/08/19/received PY - 2005/10/19/revised PY - 2005/10/25/accepted PY - 2006/2/24/pubmed PY - 2006/3/3/medline PY - 2006/2/24/entrez SP - 275.e7 EP - 14 JF - The American journal of medicine JO - Am J Med VL - 119 IS - 3 N2 - PURPOSE: US Dietary Guidelines recommend a daily sodium intake <2300 mg, but evidence linking sodium intake to mortality outcomes is scant and inconsistent. To assess the association of sodium intake with cardiovascular disease (CVD) and all-cause mortality and the potential impact of dietary sodium intake <2300 mg, we examined data from the Second National Health and Nutrition Examination Survey (NHANES II). METHODS: Observational cohort study linking sodium, estimated by single 24-hour dietary recall and adjusted for calorie intake, in a community sample (n = 7154) representing 78.9 million non-institutionalized US adults (ages 30-74). Hazard ratios (HR) for CVD and all-cause mortality were calculated from multivariable adjusted Cox models accounting for the sampling design. RESULTS: Over mean 13.7 (range: 0.5-16.8) years follow-up, there were 1343 deaths (541 CVD). Sodium (adjusted for calories) and sodium/calorie ratio as continuous variables had independent inverse associations with CVD mortality (P = .03 and P = .008, respectively). Adjusted HR of CVD mortality for sodium <2300 mg was 1.37 (95% confidence interval [CI]: 1.03-1.81, P = .033), and 1.28 (95% CI: 1.10-1.50, P = .003) for all-cause mortality. Alternate sodium thresholds from 1900-2700 mg gave similar results. Results were consistent in the majority of subgroups examined, but no such associations were observed for those <55 years old, non-whites, or the obese. CONCLUSION: The inverse association of sodium to CVD mortality seen here raises questions regarding the likelihood of a survival advantage accompanying a lower sodium diet. These findings highlight the need for further study of the relation of dietary sodium to mortality outcomes. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/16490476/Sodium_intake_and_mortality_in_the_NHANES_II_follow_up_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)01046-6 DB - PRIME DP - Unbound Medicine ER -