HealthDay News — Higher sodium and lower potassium intakes as measured in 24-hour urine samples, are associated with higher cardiovascular risk, according to a study published online November 13 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2021, held virtually from November 13 to 15.

Yuan Ma, PhD, from the Harvard T. H. Chan School of Public Health in Boston, and colleagues included individual-participant data from 6 prospective cohorts of generally healthy adults to examine sodium and potassium excretion using at least two 24-hour urine samples per participant. Cardiovascular events (coronary revascularization, fatal or nonfatal myocardial infarction, or stroke) were examined as the primary outcome.

Five hundred seventy-one cardiovascular events were ascertained during a median study follow-up of 8.8 years among 10,709 participants (incidence rate, 5.9 per 1000 person-years). The researchers found median 24-hour urinary sodium excretion to be 3270mg. In analyses controlled for confounding factors, higher sodium excretion, lower potassium excretion, and a higher sodium-to-potassium ratio were all associated with higher cardiovascular risk. Comparing quartile 4 with quartile 1 (highest vs lowest) of the urinary biomarker, the hazard ratios were 1.60, 0.69, and 1.62 for sodium excretion, potassium excretion, and sodium-to-potassium ratio, respectively. Cardiovascular risk increased 18% and decreased 18% in association with each daily increment of 1000 mg in sodium and potassium excretion, respectively (hazard ratios, 1.18 and 0.82, respectively).

“These findings may support reducing sodium intake and increasing potassium intake from current levels,” the authors write.


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Two authors disclosed financial ties to the pharmaceutical and other industries.

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