Adeola Olowu, MD

Welsh CE, Welsh P, Jhund P, Delles C, Celis-Morales C, Lewsey JD, et al. Urinary Sodium Excretion, Blood Pressure, and Risk of Future Cardiovascular Disease and Mortality in Subjects Without Prior Cardiovascular Disease. Hypertension. 2019;73:1202–1209.

The authors from the Institute of Cardiovascular and Medical Sciences, Institute of Health and Wellbeing, and Women’s Health Research Division conducted a prospective cohort study on UK Biobank participants to determine if a common lab value — Urinary Sodium Excretion — could affect mortality or the development of cardiovascular disease determine future cardiovascular disease.

A total of 457,484 participants were prospectively evaluated for the development of cardiovascular disease over approximately 7 years. These participants did not have any cardiovascular conditions such as heart disease, hypertension, or diabetes.

Patients were evaluated in quintiles for MABP and Urinary Na Excretion. Significant associations amongst the quintiles for both MABP and Urinary Na Excretion were age, a White ethnic background, BMI, lean body mass, family history of CVD, participants who have never smoked, Townsend deprivation index, rheumatoid arthritis, baseline CVD, antihypertensive medications, and diabetes.  

Atrial fibrillation was a significant association in analyzing the participants in Urinary Na Excretion quintiles.

For CVD analysis, participants being treated with hypertension, baseline DM or CVD were excluded. Amongst the total amount of participants observed, a total of 1104 (0.2%) participants died secondary to cardiovascular events. Of the 1104 participants who died, 740 were men (67%) and 364 (33%) were women. 

No association was found between urinary sodium (high or low) and risk of developing cardiovascular disease, including heart failure.

The results of this study are interesting. We practice that lower sodium intake will decrease cardiovascular risk. When it comes to lifestyle modifications, should the emphasis be more on exercise?

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