To further explore the potential effect of imbalanced confounders, we performed propensity-score–matched sensitivity analyses 30 that compared a high estimated sodium excretion (?6.00 g per day) with a moderate level (3.00 to 5.99 g per day) and that compared a low estimated sodium excretion (<3.00 g per day) with the moderate level. In a secondary analysis, we examined the association between an estimated “usual” level of sodium or potassium excretion and death and cardiovascular disease, with correction for regression dilution bias (with the use of repeated measurements in 448 participants). 31 All analyses were conducted with the use of SAS software, version 9.2, for the UNIX operating system (SAS Institute).
Data Members and you may Effects
The study included 101,945 participants, 42% of whom were from China. The mean estimated 24-hour sodium excretion was 4.93 g, and the mean estimated 24-hour potassium excretion was 2.12 g ( Table 1 , and Table S1 in the Supplementary Appendix). The mean systolic and diastolic blood pressures were higher among participants with a higher estimated sodium excretion (P<0.001). The mean duration of follow-up was 3.7 years, with follow-up completed for 95% of the participants. The primary composite outcome of death or a major cardiovascular event occurred in 3317 participants (3.3%): 1976 participants died (650 from cardiovascular causes), 857 had myocardial infarction, 872 had stroke, and 261 had heart failure. Participants may have had more than one cardiovascular event.
Panel A shows a finite-cubic-spline patch of your own relationship between estimated 24-hr urinary sodium removal additionally the composite consequence of passing out-of any result in and you may significant aerobic incidents. The new spline bend is actually truncated in the g everyday (experiences speed certainly participants that have salt excretion > grams everyday, 8 situations in the 305 players). Panel B shows a restricted-cubic-spline spot of your organization anywhere between projected salt removal and you may demise. The event rate among people having salt excretion greater than g just about every day was 5 occurrences when you look at the 305 Edmonton Canada free hookup players. Panel C shows a small-cubic-spline spot of your relationship anywhere between projected sodium excretion and you will significant cardio incidents (identified as death away from aerobic factors, myocardial infarction, heart attack, otherwise cardio failure). Case speed certainly one of people which have salt excretion greater than g every day is six occurrences when you look at the 305 players. Most of the plots was in fact modified to own many years, sex, geographic area, educational peak, ancestry (Western versus. non-Asian), alcohol consumption, body-bulk directory, and you can updates regarding all forms of diabetes mellitus, reputation for cardio occurrences, and you may current smoking. Dashed outlines suggest 95% believe durations. The new median sodium removal (cuatro.72 grams daily) is the latest site simple, expressed by the red range. To convert the prices to own estimated sodium excretion so you can salt consumption during the g every day, multiply from the 2.5.
Than an estimated sodium removal from cuatro.00 to help you 5.99 g on a daily basis (the latest resource class), estimated excretion from 7.00 g a day or maybe more was from the increased risks of the no. 1 chemical consequences (opportunity ratio, step one.15; 95% believe period [CI], step one.02 to a single.30), demise away from any result in (possibility ratio, step one.25; 95% CI, step 1.07 to 1.48), a primary cardiovascular skills (possibility proportion, step 1.16; 95% CI, 1.01 to 1.34), passing out-of aerobic reasons (chance ratio, step 1.54; 95% CI, step 1.21 to 1.95), and you will stroke leading to passing or hospitalization (possibility proportion, step 1.29; 95% CI, step one.02 to just one.63) to the multivariable research ( Desk dos and you will Profile step one , and you will Desk S2 in the Second Appendix). The fresh new relationship between a high projected sodium removal (?7.00 grams a-day) plus the number one substance benefit, big cardiovascular incidents, and you can coronary arrest leading to death otherwise hospitalization is actually attenuated and you may is not significant shortly after adjustment having blood pressure otherwise earlier in the day prognosis regarding hypertension however, stayed extreme having death of one end up in ( Desk dos , and you will Dining table S2 on the Supplementary Appendix).