Sodium-containing acetaminophen and cardiovascular outcomes in individuals with and without hypertension.

Abstract

AIMS:

Previous studies have found high sodium intake to be associated with increased risks of cardiovascular disease (CVD) and all-cause mortality among individuals with hypertension; findings on the effect of intake among individuals without hypertension have been equivocal. We aimed to compare the risks of incident CVD and all-cause mortality among initiators of sodium-containing acetaminophen with the risk of initiators of non-sodium-containing formulations of the same drug according to the history of hypertension.

METHODS AND RESULTS:

Using The Health Improvement Network, we conducted two cohort studies among individuals with and without hypertension. We examined the relation of sodium-containing acetaminophen to the risk of each outcome during 1-year follow-up using marginal structural models with an inverse probability weighting to adjust for time-varying confounders. The outcomes were incident CVD (myocardial infarction, stroke, and heart failure) and all-cause mortality. Among individuals with hypertension (mean age: 73.4 years), 122 CVDs occurred among 4532 initiators of sodium-containing acetaminophen (1-year risk: 5.6%) and 3051 among 146 866 non-sodium-containing acetaminophen initiators (1-year risk: 4.6%). The average weighted hazard ratio (HR) was 1.59 [95% confidence interval (CI) 1.32-1.92]. Among individuals without hypertension (mean age: 71.0 years), 105 CVDs occurred among 5351 initiators of sodium-containing acetaminophen (1-year risk: 4.4%) and 2079 among 141 948 non-sodium-containing acetaminophen initiators (1-year risk: 3.7%), with an average weighted HR of 1.45 (95% CI 1.18-1.79). Results of specific CVD outcomes and all-cause mortality were similar.

CONCLUSION:

The initiation of sodium-containing acetaminophen was associated with increased risks of CVD and all-cause mortality among individuals with or without hypertension. Our findings suggest that individuals should avoid unnecessary excessive sodium intake through sodium-containing acetaminophen use.

• Authors: Chao Zeng, Lynn Rosenberg, Xiaoxiao Li, Luc Djousse, Jie Wei, Guanghua Lei, Yuqing Zhang
• Journal: European heart journal (Eur Heart J) Vol. 43 Issue 18 Pg. 1743-1755 (05 07 2022) ISSN: 1522-9645 [Electronic] England
• PMID: 35201347 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology.

Chemical References

• Sodium, Dietary
• Acetaminophen
• Sodium

Topics

• Acetaminophen (adverse effects)
• Aged
• Cardiovascular Diseases (epidemiology)
• Humans
• Hypertension (drug therapy, epidemiology)
• Myocardial Infarction
• Risk Factors
• Sodium
• Sodium, Dietary