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Sodium intake and mortality follow-up in the Third National Health and Nutrition Examination Survey (NHANES III).
J Gen Intern Med. 2008 Sep; 23(9):1297-302.JG

Abstract

BACKGROUND

Sodium restriction is commonly recommended as a measure to lower blood pressure and thus reduce cardiovascular disease (CVD) and all-cause mortality. However, some studies have observed higher mortality associated with lower sodium intake.

OBJECTIVE

To test the hypothesis that lower sodium is associated with subsequent higher cardiovascular disease (CVD) and all cause mortality in the Third National Health and Nutrition Examination Survey (NHANES III).

DESIGN

Observational cohort study of mortality subsequent to a baseline survey.

PARTICIPANTS

Representative sample (n = 8,699) of non-institutionalized US adults age > or = 30, without history of CVD events, recruited between 1988-1994.

MEASUREMENTS AND MAIN RESULTS

Dietary sodium and calorie intakes estimated from a single baseline 24-h dietary recall. Vital status and cause of death were obtained from the National Death Index through the year 2000. Hazard ratio (HR) for CVD mortality of lowest to highest quartile of sodium, adjusted for calories and other CVD risk factors, in a Cox model, was 1.80 (95% CI 1.05, 3.08, p = 0.03). Non-significant trends of an inverse association of continuous sodium (per 1,000 mg) intake with CVD and all-cause mortality were observed with a 99% CI of 0.73, 1.06 (p = 0.07) and 0.86, 1.04 (p = 0.11), respectively, while trends for a direct association were not observed.

CONCLUSION

Observed associations of lower sodium with higher mortality were modest and mostly not statistically significant. However, these findings also suggest that for the general US adult population, higher sodium is unlikely to be independently associated with higher CVD or all-cause mortality.

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 available

Pub Type(s)

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

Language

eng

PubMed ID

18465175

Citation

Cohen, Hillel W., et al. "Sodium Intake and Mortality Follow-up in the Third National Health and Nutrition Examination Survey (NHANES III)." Journal of General Internal Medicine, vol. 23, no. 9, 2008, pp. 1297-302.
Cohen HW, Hailpern SM, Alderman MH. Sodium intake and mortality follow-up in the Third National Health and Nutrition Examination Survey (NHANES III). J Gen Intern Med. 2008;23(9):1297-302.
Cohen, H. W., Hailpern, S. M., & Alderman, M. H. (2008). Sodium intake and mortality follow-up in the Third National Health and Nutrition Examination Survey (NHANES III). Journal of General Internal Medicine, 23(9), 1297-302. https://doi.org/10.1007/s11606-008-0645-6
Cohen HW, Hailpern SM, Alderman MH. Sodium Intake and Mortality Follow-up in the Third National Health and Nutrition Examination Survey (NHANES III). J Gen Intern Med. 2008;23(9):1297-302. PubMed PMID: 18465175.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sodium intake and mortality follow-up in the Third National Health and Nutrition Examination Survey (NHANES III). AU - Cohen,Hillel W, AU - Hailpern,Susan M, AU - Alderman,Michael H, Y1 - 2008/05/09/ PY - 2007/10/24/received PY - 2008/04/16/accepted PY - 2008/02/27/revised PY - 2008/5/10/pubmed PY - 2008/12/17/medline PY - 2008/5/10/entrez SP - 1297 EP - 302 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 23 IS - 9 N2 - BACKGROUND: Sodium restriction is commonly recommended as a measure to lower blood pressure and thus reduce cardiovascular disease (CVD) and all-cause mortality. However, some studies have observed higher mortality associated with lower sodium intake. OBJECTIVE: To test the hypothesis that lower sodium is associated with subsequent higher cardiovascular disease (CVD) and all cause mortality in the Third National Health and Nutrition Examination Survey (NHANES III). DESIGN: Observational cohort study of mortality subsequent to a baseline survey. PARTICIPANTS: Representative sample (n = 8,699) of non-institutionalized US adults age > or = 30, without history of CVD events, recruited between 1988-1994. MEASUREMENTS AND MAIN RESULTS: Dietary sodium and calorie intakes estimated from a single baseline 24-h dietary recall. Vital status and cause of death were obtained from the National Death Index through the year 2000. Hazard ratio (HR) for CVD mortality of lowest to highest quartile of sodium, adjusted for calories and other CVD risk factors, in a Cox model, was 1.80 (95% CI 1.05, 3.08, p = 0.03). Non-significant trends of an inverse association of continuous sodium (per 1,000 mg) intake with CVD and all-cause mortality were observed with a 99% CI of 0.73, 1.06 (p = 0.07) and 0.86, 1.04 (p = 0.11), respectively, while trends for a direct association were not observed. CONCLUSION: Observed associations of lower sodium with higher mortality were modest and mostly not statistically significant. However, these findings also suggest that for the general US adult population, higher sodium is unlikely to be independently associated with higher CVD or all-cause mortality. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/18465175/Sodium_intake_and_mortality_follow_up_in_the_Third_National_Health_and_Nutrition_Examination_Survey__NHANES_III__ L2 - https://dx.doi.org/10.1007/s11606-008-0645-6 DB - PRIME DP - Unbound Medicine ER -