Measuring Children’s Sodium and Potassium Intakes in New Zealand: A Pilot Study

AbstractObjectiveTo evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.DesignInternational prospective cohort study.Setting18 high, middle, and low income countries, sampled from urban and rural communities.Participants103 570 people who provided morning fasting urine samples.Main outcome measuresAssociation of estimated 24 hour urinary sodium and potassium excretion (surrogates for intake) with all cause mortality and major cardiovascular events, using multivariable Cox regression. A six category variable for joint sodium and potassium was generated: sodium excretion (low (<3 g/day), moderate (3-5 g/day), and high (>5 g/day) sodium intakes) by potassium excretion (greater/equal or less than median 2.1 g/day).ResultsMean estimated sodium and potassium urinary excretion were 4.93 g/day and 2.12 g/day, respectively. After a median follow-up of 8.2 years, 7884 (6.1%) participants had died or experienced a major cardiovascular event. Increasing urinary sodium excretion was positively associated with increasing potassium excretion (unadjusted r=0.34), and only 0.002% had a concomitant urinary excretion of <2.0 g/day of sodium and >3.5 g/day of potassium. A J-shaped association was observed of sodium excretion and inverse association of potassium excretion with death and cardiovascular events. For joint sodium and potassium excretion categories, the lowest risk of death and cardiovascular events occurred in the group with moderate sodium excretion (3-5 g/day) and higher potassium excretion (21.9% of cohort). Compared with this reference group, the combinations of low potassium with low sodium excretion (hazard ratio 1.23, 1.11 to 1.37; 7.4% of cohort) and low potassium with high sodium excretion (1.21, 1.11 to 1.32; 13.8% of cohort) were associated with the highest risk, followed by low sodium excretion (1.19, 1.02 to 1.38; 3.3% of cohort) and high sodium excretion (1.10, 1.02 to 1.18; 29.6% of cohort) among those with potassium excretion greater than the median. Higher potassium excretion attenuated the increased cardiovascular risk associated with high sodium excretion (P for interaction=0.007).ConclusionsThese findings suggest that the simultaneous target of low sodium intake (<2 g/day) with high potassium intake (>3.5 g/day) is extremely uncommon. Combined moderate sodium intake (3-5 g/day) with high potassium intake is associated with the lowest risk of mortality and cardiovascular events.

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Urinary Sodium and Potassium, and Risk of Ischaemic and Haemorrhagic Stroke (INTERSTROKE): a case-control study

American Journal of Hypertension ◽

10.1093/ajh/hpaa176 ◽

2020 ◽

Author(s):

Conor Judge ◽

Martin J O’Donnell ◽

Graeme J Hankey ◽

Sumathy Rangarajan ◽

Siu Lim Chin ◽

...

Keyword(s):

Ischemic Stroke ◽

Sodium Excretion ◽

Stroke Risk ◽

Sodium Intake ◽

Urinary Sodium ◽

Potassium Excretion ◽

High Potassium ◽

Potassium Intake ◽

Low Sodium ◽

Sodium And Potassium

Abstract Background Although low sodium intake (<2g/day) and high potassium intake (>3·5g/day) are proposed as public health interventions to reduce stroke risk, there is uncertainty about the benefit and feasibility of this combined recommendation on prevention of stroke and its subtypes. Methods We obtained random urine samples from 9,275 cases of acute first stroke and 9,726 matched controls (8,761 matched pairs for conditional analysis) from 27 countries and estimated the 24-hour sodium and potassium excretion, a surrogate for intake, using the Tanaka formula. Using multivariable conditional logistic regression, we determined the associations of estimated 24-hour urinary sodium and potassium excretion with stroke and its subtypes. Results The mean estimated 24-hour sodium and potassium urinary excretion was 3·29g/day and 1·57g/day, with 0·01% of participants having both low sodium (<2·0g/day) and high potassium excretion (>3·5g/day). There was a moderate positive correlation between sodium and potassium excretion (r=0·4435, P<0.001) and between sodium excretion and blood pressure (P<0.001). Compared with an estimated urinary sodium excretion of 2·8-3·5g/day (second quartile, reference), higher (>4·26g/day) (OR 1.81;95%CI,1.65-2.00) and lower (<2·8g/day) sodium excretion (OR 1.39;95%CI,1.26-1.53) were significantly associated with increased risk of stroke. The stroke risk associated with the highest quartile of sodium intake (sodium excretion >4·26g/day) was significantly greater (P<0.001) for intracerebral haemorrhage (ICH) (OR 2.38;95%CI,1.93-2.92) than for ischemic stroke (OR 1.67;95%CI,1.50-1.87), and greater for large vessel and small vessel ischemic stroke than for cardioembolic ischemic stroke. Urinary potassium was inversely and linearly associated with risk of stroke, and stronger for ischemic stroke than ICH (P=0.026). In an analysis of combined sodium and potassium excretion, the combination of high potassium intake (>1·58g/day) and moderate sodium intake (2.8-3.5 g/day) was associated with the lowest risk of stroke. Conclusion The association of sodium intake and stroke is J-shaped, with high sodium intake a stronger risk factor for intracerebral haemorrhage than ischemic stroke. Our data suggest that moderate sodium intake – rather than low sodium intake – combined with high potassium intake may be associated with the lowest risk of stroke and expected to be a more feasible combined dietary target.

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The role of very low birth weight and prematurity on cardiovascular disease risk and on kidney development in children: a pilot study

Minerva Pediatrica ◽

10.23736/s0026-4946.16.04520-5 ◽

2020 ◽

Vol 72 (3) ◽

Cited By ~ 1

Author(s):

Marco M. Ciccone ◽

Francesca Cortese ◽

Michele Gesualdo ◽

Antonio Di Mauro ◽

Silvio Tafuri ◽

...

Keyword(s):

Cardiovascular Disease ◽

Birth Weight ◽

Pilot Study ◽

Low Birth Weight ◽

Kidney Development ◽

Very Low Birth Weight ◽

Disease Risk ◽

Cardiovascular Disease Risk

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NT-PROBNP AND THE CUT-OFF VALUE IN CARDIOVASCULAR DISEASES

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.1 ◽

2011 ◽

pp. 5-12

Author(s):

Anh Tien Hoang ◽

Van Minh Huynh ◽

Khanh Hoang ◽

Huu Dang Tran ◽

Viet An Tran

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Pilot Study ◽

Cardiovascular Diseases ◽

Clinical Application ◽

European Society ◽

The Other ◽

Cardiac Marker ◽

Cardiac Biomarker ◽

European Society Of Cardiology

NT-ProBNP is a high value cardiac biomarker and widely applies in many cardiovascular diseases. The evaluation of concentration of NT-ProBNP needs the concern about age, gender, obesity and especially we need each cut-off point for each cause of cardiovascular disease in evaluation and clinical application. Because NT-ProBNP is a new cardiac marker and has been researched in 5 recent years, the cut-off of NT-ProBNP is still being studied for the clinical application in cardiovascular diseases. Only the cut-off of NT-ProBNP in diagnosis heart failure was guided by European Society of Cardiology. The meaning of introduce cut-off value of value plays an role as pilot study for the other relate study and brings the NT-ProBNP closely approach to clinical application.

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