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Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey.
Arch Intern Med. 2011 Jul 11; 171(13):1183-91.AI

Abstract

BACKGROUND

Several epidemiologic studies suggested that higher sodium and lower potassium intakes were associated with increased risk of cardiovascular diseases (CVD). Few studies have examined joint effects of dietary sodium and potassium intake on risk of mortality.

METHODS

To investigate estimated usual intakes of sodium and potassium as well as their ratio in relation to risk of all-cause and CVD mortality, the Third National Health and Nutrition Examination Survey Linked Mortality File (1988-2006), a prospective cohort study of a nationally representative sample of 12,267 US adults, studied all-cause, cardiovascular, and ischemic heart (IHD) diseases mortality.

RESULTS

During a mean follow-up period of 14.8 years, we documented a total of 2270 deaths, including 825 CVD deaths and 443 IHD deaths. After multivariable adjustment, higher sodium intake was associated with increased all-cause mortality (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.03-1.41 per 1000 mg/d), whereas higher potassium intake was associated with lower mortality risk (HR, 0.80; 95% CI, 0.67-0.94 per 1000 mg/d). For sodium-potassium ratio, the adjusted HRs comparing the highest quartile with the lowest quartile were HR, 1.46 (95% CI, 1.27-1.67) for all-cause mortality; HR, 1.46 (95% CI, 1.11-1.92) for CVD mortality; and HR, 2.15 (95% CI, 1.48-3.12) for IHD mortality. These findings did not differ significantly by sex, race/ethnicity, body mass index, hypertension status, education levels, or physical activity.

CONCLUSION

Our findings suggest that a higher sodium-potassium ratio is associated with significantly increased risk of CVD and all-cause mortality, and higher sodium intake is associated with increased total mortality in the general US population.

Authors+Show Affiliations

Division for Heart Diseases and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mail Stop K-47, Atlanta, GA 30341, USA. qay0@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21747015

Citation

Yang, Quanhe, et al. "Sodium and Potassium Intake and Mortality Among US Adults: Prospective Data From the Third National Health and Nutrition Examination Survey." Archives of Internal Medicine, vol. 171, no. 13, 2011, pp. 1183-91.
Yang Q, Liu T, Kuklina EV, et al. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2011;171(13):1183-91.
Yang, Q., Liu, T., Kuklina, E. V., Flanders, W. D., Hong, Y., Gillespie, C., Chang, M. H., Gwinn, M., Dowling, N., Khoury, M. J., & Hu, F. B. (2011). Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine, 171(13), 1183-91. https://doi.org/10.1001/archinternmed.2011.257
Yang Q, et al. Sodium and Potassium Intake and Mortality Among US Adults: Prospective Data From the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2011 Jul 11;171(13):1183-91. PubMed PMID: 21747015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. AU - Yang,Quanhe, AU - Liu,Tiebin, AU - Kuklina,Elena V, AU - Flanders,W Dana, AU - Hong,Yuling, AU - Gillespie,Cathleen, AU - Chang,Man-Huei, AU - Gwinn,Marta, AU - Dowling,Nicole, AU - Khoury,Muin J, AU - Hu,Frank B, PY - 2011/7/13/entrez PY - 2011/7/13/pubmed PY - 2011/9/2/medline SP - 1183 EP - 91 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 171 IS - 13 N2 - BACKGROUND: Several epidemiologic studies suggested that higher sodium and lower potassium intakes were associated with increased risk of cardiovascular diseases (CVD). Few studies have examined joint effects of dietary sodium and potassium intake on risk of mortality. METHODS: To investigate estimated usual intakes of sodium and potassium as well as their ratio in relation to risk of all-cause and CVD mortality, the Third National Health and Nutrition Examination Survey Linked Mortality File (1988-2006), a prospective cohort study of a nationally representative sample of 12,267 US adults, studied all-cause, cardiovascular, and ischemic heart (IHD) diseases mortality. RESULTS: During a mean follow-up period of 14.8 years, we documented a total of 2270 deaths, including 825 CVD deaths and 443 IHD deaths. After multivariable adjustment, higher sodium intake was associated with increased all-cause mortality (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.03-1.41 per 1000 mg/d), whereas higher potassium intake was associated with lower mortality risk (HR, 0.80; 95% CI, 0.67-0.94 per 1000 mg/d). For sodium-potassium ratio, the adjusted HRs comparing the highest quartile with the lowest quartile were HR, 1.46 (95% CI, 1.27-1.67) for all-cause mortality; HR, 1.46 (95% CI, 1.11-1.92) for CVD mortality; and HR, 2.15 (95% CI, 1.48-3.12) for IHD mortality. These findings did not differ significantly by sex, race/ethnicity, body mass index, hypertension status, education levels, or physical activity. CONCLUSION: Our findings suggest that a higher sodium-potassium ratio is associated with significantly increased risk of CVD and all-cause mortality, and higher sodium intake is associated with increased total mortality in the general US population. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/21747015/Sodium_and_potassium_intake_and_mortality_among_US_adults:_prospective_data_from_the_Third_National_Health_and_Nutrition_Examination_Survey_ DB - PRIME DP - Unbound Medicine ER -