Journal ArticleDOI
Low Urinary Sodium Is Associated With Greater Risk of Myocardial Infarction Among Treated Hypertensive Men
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TLDR
Myocardial infarction and UNaV were inversely associated in the total population and in men but not in women, who sustained only nine events, and no association was observed between non-cardiovascular disease mortality andUNaV.Abstract:
A sodium-reduced diet is frequently recommended for hypertensive individuals. To determine the relationship of sodium intake to subsequent cardiovascular disease, we assessed the experience of participants in a worksite-based cohort of hypertensive subjects. The 24-hour urinary excretion of sodium (UNaV), potassium, creatinine, and plasma renin activity was measured in 2937 mildly and moderately hypertensive subjects who were unmedicated for at least 3-4 weeks. Morbidity and mortality in these systematically treated subjects were ascertained. Men and women were stratified according to sex-specific quartiles of UNaV. Subjects in these strata were similar in race, cardiovascular status, and pretreatment and intreatment blood pressure. Subjects with lower UNaV were thinner, excreted less potassium, and had higher plasma renin activity. During an average 3.8 years of follow-up, a total of 55 myocardial infarctions occurred. Myocardial infarction and UNaV were inversely associated in the total population and in men but not in women, who sustained only nine events. In men, age- and race-adjusted myocardial infarction incidence in the lowest versus highest UNaV quartile was 11.5 versus 2.5 (relative risk, 4.3, 95% confidence interval, 1.7-10.6). No association was observed between non-cardiovascular disease mortality (n = 11) and UNaV. There was a significant linear trend in proportions of myocardial infarction by UNaV quartile, with a break point after the lowest UNaV quartile.(ABSTRACT TRUNCATED AT 250 WORDS)read more
Citations
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The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (NIH Publication No. 98-4080)
Black Hr,Cohen Jd,Kaplan Nm,Ferdinand Kc,Chobanian Av,Dustan Hp,Gifford Rw,M. Moser,Sheps Sg,L. Agodoa,August Pa,Bakris Gl,V. Burt,W. Busse,Carter Bl,Chesley Fd,J. Cleeman,Cohn Jn,Cregler Ll,C. Crespo,Cushman Wc,J. Cutler,Darrow Md,DeQuattro Vl,Devereux Rb,Dworkin Ld,Elliott Wj,M. Epstein,B. Falkner,Ferrario Cm,Flack Jm,W. Frishman,Frohlich Ed,Green La,Grimm Rh,Hagberg Jm,Hall Wd,J. Handler,S. Havas,Hill Mn,Horan Mj,Hsueh Wa,Hyman Bn,Izzo Jl,K. Jamerson,Kiley Jp,Kochar Ms,Kolasa Km,Krakoff Lr,D. Levy,Lindheimer Md,Luepker Rv,Malone Mel,B. Massie,Materson Bj,J. Merchant,Messerli Fh,Miller Nh,Moore Ma,L. MustoneAlexander,S. Oparil,Perry Hm,Pickering Tg,Pratt Jh,Ram Cvs,Randall Os,Reed Jw,Roberts Rw,Roccella Ej,Rogus Sd,E. Saunders,E. Schron,G. Schwartz,Sibai Bm,D. Snyder,Sowers Jr,J. Stamler,R. Temple,S. Textor,T. Thom,Vidt Dg,M. Weber,Weinberger Mh,R. Weinshilboum,Whelton Pk,Whisnant Jp,Wiebers Do,Winston Mc,Wright Jt,C. Lenfant,L. Casser,Colman Pj,T. Edwards,Feeley Dm,J. Gajewski,D. Levine,W. Manger,Marshall Ec,Nickey Wa,Robert Rw,Secrest Bg,Singer Eh,Wilson Gj,Young Jm,Bachman Jw,Campese Vm,Carr Aa,M. Hand,Holden Dc,Jamieson Mj,S. Julius,Mensah Ga,M. Prisant,Sullivan Jm,Wilson Dj,G. Morosco,Anderson De,D. Waugh +117 more
TL;DR: In older persons, diuretics are preferred and long-acting dihydropyridine calcium antagonists may be considered and specific therapy for patients with LVH, coronary artery disease, and heart failure are outlined.
Journal ArticleDOI
Potassium intake, stroke, and cardiovascular disease: a meta-analysis of prospective studies
TL;DR: In this paper, the relation between the level of habitual salt intake and stroke or total cardiovascular disease outcome was assessed by a systematic review and meta-analysis of prospective studies published 1966-2008.
Journal ArticleDOI
Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)
Nancy R. Cook,Jeffrey A. Cutler,Eva Obarzanek,Julie E. Buring,Kathryn M. Rexrode,Shiriki K. Kumanyika,Lawrence J. Appel,Paul K. Whelton +7 more
TL;DR: Sodium reduction, previously shown to lower blood pressure, may also reduce long term risk of cardiovascular events.
Journal ArticleDOI
Sodium Reduction and Weight Loss in the Treatment of Hypertension in Older Persons: A Randomized Controlled Trial of Nonpharmacologic Interventions in the Elderly (TONE)
Paul K. Whelton,Lawrence J. Appel,Mark A. Espeland,William B. Applegate,Walter H. Ettinger,John B. Kostis,Shiriki K. Kumanyika,Shiriki K. Kumanyika,Clifton R. Lacy,Karen C. Johnson,Steven Folmar,Jeffrey A. Cutler +11 more
TL;DR: Reduced sodium intake and weight loss constitute a feasible, effective, and safe nonpharmacologic therapy of hypertension in older persons.
Journal ArticleDOI
A comprehensive review on salt and health and current experience of worldwide salt reduction programmes.
Feng J. He,Graham A. MacGregor +1 more
TL;DR: There is strong evidence that the authors' current consumption of salt is the major factor increasing BP and thereby CVD, and a modest reduction in population salt intake worldwide will result in a major improvement in public health.
References
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Book ChapterDOI
Regression Models and Life-Tables
TL;DR: The analysis of censored failure times is considered in this paper, where the hazard function is taken to be a function of the explanatory variables and unknown regression coefficients multiplied by an arbitrary and unknown function of time.
Journal ArticleDOI
Prediction of Creatinine Clearance from Serum Creatinine
Donald W. Cockcroft,M H Gault +1 more
TL;DR: A formula has been developed to predict Creatinine clearance from serum creatinine (Scr) in adult males: Ccr = (140 – age) (wt kg)/72 × Scr (mg/100ml) (15% less i).
Journal ArticleDOI
Blood pressure, stroke, and coronary heart disease: Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias
Stephen MacMahon,Richard Peto,J E Cutler,Rory Collins,P D Sorlie,James D. Neaton,Robert D. Abbott,Jon Godwin,Alan R. Dyer,Jeremiah Stamler +9 more
TL;DR: The DBP results suggest that for the large majority of individuals, whether conventionally "hypertensive" or "normotensive", a lower blood pressure should eventually confer a lower risk of vascular disease.
Journal ArticleDOI
Intersalt: An international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion
TL;DR: Body mass index and heavy alcohol intake had strong, significant independent relations with blood pressure in individual subjects, and the relation of sodium to potassium ratio to blood pressure followed a pattern similar to that of sodium.