Urinary Potassium, Sodium Excretion Tied to CV Events

Compared with baseline sodium excretion, high or low excretion linked with increased CV events

TUESDAY, Nov. 22 (HealthDay News) -- Estimated urinary sodium and potassium excretion are associated with cardiovascular (CV) events, according to a study published in the Nov. 23/30 issue of the Journal of the American Medical Association.

Martin J. O'Donnell, M.B., Ph.D., from Hamilton General Hospital in Canada, and colleagues investigated the association between estimated urinary sodium and potassium excretion and CV events in 28,880 patients with established CV disease or diabetes mellitus. Morning fasting urine samples were used to estimate 24-hour urinary sodium and potassium excretion. The reference categories for sodium and potassium excretion were identified using restricted cubic spine plots. CV death, myocardial infarction (MI), stroke, and hospitalization for congestive heart failure were the main outcome measures.

The investigators found the mean estimated 24-hour excretion for sodium and potassium to be 4.77 and 2.19 g, respectively, at baseline. The composite outcome occurred in 4,729 participants after a median follow-up of 56 months (2,057 CV deaths, 1,412 MIs, 1,282 strokes, 1,213 hospitalizations for congestive heart failure). Compared with estimated baseline sodium excretion of 4 to 5.99 g/day, higher baseline sodium excretion was associated with an increased risk of CV death, stroke, and hospitalization for congestive heart failure. Multivariable analysis revealed an association between lower sodium excretion and increased risk of CV death and hospitalization for congestive heart failure. Higher potassium excretion was associated with reduced risk of stroke, compared with estimated potassium excretion of less than 1.5 g/day.

"The association between estimated sodium excretion and CV events was J-shaped," the authors write. "Higher estimated potassium excretion was associated with a reduced risk of stroke."

Several study authors disclosed financial relationships with pharmaceutical companies, including Boehringer-Ingelheim, which supported the study.

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