Sodium excretion and risk of developing coronary heart disease.

Abstract

BACKGROUND:

Despite compelling evidence for sodium's adverse effects on blood pressure, it remains uncertain whether excess sodium intake is a risk factor for coronary heart disease (CHD) in the overall population and in potentially more susceptible subgroups.

METHODS AND RESULTS:

We prospectively followed 7543 adults aged 28 to 75 years and free of cardiovascular and kidney disease in 1997/1998 of the Prevention of Renal and Vascular End-stage Disease (PREVEND) study. Sodium excretion was measured in two 24-hour urine collections at baseline. Potential susceptibility factors were blood pressure and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP). Median 24-hour sodium excretion was 137 mmol (Q1-Q3, 106-171 mmol). During a median follow-up of 10.5 (Q1-Q3: 9.9-10.8) years, 452 CHD events occurred. In the entire cohort, there was no association between each 1-g/d (43 mmol/24 h) increment in sodium excretion and CHD risk (adjusted hazard ratio, 1.07; 95% confidence interval, 0.98-1.18; P=0.15). However, the association of sodium excretion with CHD risk tended to be modified by mean arterial pressure (Pinteraction=0.08) and was modified by NT-proBNP (Pinteraction=0.002). When stratified, each 1-g/d increment in sodium excretion was associated with an increased risk for CHD in subjects with hypertension (adjusted hazard ratio, 1.14; 95% confidence interval, 1.01-1.28; n=2363) and in subjects with NT-proBNP concentrations above the sex-specific median (adjusted hazard ratio, 1.16; 95% confidence interval, 1.03-1.30; n=3771).

CONCLUSIONS:

Overall, there was no association between sodium excretion and risk of CHD. The association between sodium excretion and CHD risk was modified by NT-proBNP. Higher sodium excretion was associated with an increased CHD risk among subjects with increased NT-proBNP concentrations or with hypertension.

• Authors: Michel M Joosten, Ron T Gansevoort, Kenneth J Mukamal, Hiddo J Lambers Heerspink, Johanna M Geleijnse, Edith J M Feskens, Gerjan Navis, Stephan J L Bakker, PREVEND Study Group
• Journal: Circulation (Circulation) Vol. 129 Issue 10 Pg. 1121-8 (Mar 11 2014) ISSN: 1524-4539 [Electronic] United States
• PMID: 24425751 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• Sodium

Topics

• Adult
• Aged
• Biomarkers (metabolism)
• Blood Pressure (physiology)
• Circadian Rhythm (physiology)
• Cohort Studies
• Coronary Disease (epidemiology, metabolism, physiopathology)
• Female
• Humans
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Prospective Studies
• Retrospective Studies
• Risk Factors
• Sodium (urine)