TY - JOUR
T1 - Associations of Biomarker-Calibrated Sodium and Potassium Intakes with Cardiovascular Disease Risk among Postmenopausal Women
AU - Prentice, Ross L.
AU - Huang, Ying
AU - Neuhouser, Marian L.
AU - Manson, Joann E.
AU - Mossavar-Rahmani, Yasmin
AU - Thomas, Fridtjof
AU - Tinker, Lesley F.
AU - Allison, Matthew
AU - Johnson, Karen C.
AU - Wassertheil-Smoller, Sylvia
AU - Seth, Arjun
AU - Rossouw, Jacques E.
AU - Shikany, James
AU - Carbone, Laura D
AU - Martin, Lisa W.
AU - Stefanick, Marcia L.
AU - Haring, Bernhard
AU - Van Horn, Linda
N1 - Publisher Copyright:
© The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Studies of the associations of sodium and potassium intakes with cardiovascular disease incidence often rely on self-reported dietary data. In the present study, self-reported intakes from postmenopausal women at 40 participating US clinical centers are calibrated using 24-hour urinary excretion measures in cohorts from the Women's Health Initiative, with follow-up from 1993 to 2010. The incidence of hypertension was positively related to (calibrated) sodium intake and to the ratio of sodium to potassium. The sodium-to-potassium ratio was associated with cardiovascular disease incidence during an average follow-up period of 12 years. The estimated hazard ratio for a 20% increase in the sodium-to-potassium ratio was 1.13 (95% confidence interval (CI): 1.04, 1.22) for coronary heart disease, 1.20 (95% CI: 1.01, 1.42) for heart failure, and 1.11 (95% CI: 1.04, 1.19) for a composite cardiovascular disease outcome. The association with total stroke was not significant, but it was positive for ischemic stroke and inverse for hemorrhagic stroke. Aside from hemorrhagic stroke, corresponding associations of cardiovascular disease with sodium and potassium jointly were positive for sodium and inverse for potassium, although some were not statistically significant. Specifically, for coronary heart disease, the hazard ratios for 20% increases were 1.11 (95% CI: 0.95, 1.30) for sodium and 0.85 (95% CI: 0.73, 0.99) for potassium; and corresponding values for heart failure were 1.36 (95% CI: 1.02, 1.82) for sodium and 0.90 (95% CI: 0.69, 1.18) for potassium.
AB - Studies of the associations of sodium and potassium intakes with cardiovascular disease incidence often rely on self-reported dietary data. In the present study, self-reported intakes from postmenopausal women at 40 participating US clinical centers are calibrated using 24-hour urinary excretion measures in cohorts from the Women's Health Initiative, with follow-up from 1993 to 2010. The incidence of hypertension was positively related to (calibrated) sodium intake and to the ratio of sodium to potassium. The sodium-to-potassium ratio was associated with cardiovascular disease incidence during an average follow-up period of 12 years. The estimated hazard ratio for a 20% increase in the sodium-to-potassium ratio was 1.13 (95% confidence interval (CI): 1.04, 1.22) for coronary heart disease, 1.20 (95% CI: 1.01, 1.42) for heart failure, and 1.11 (95% CI: 1.04, 1.19) for a composite cardiovascular disease outcome. The association with total stroke was not significant, but it was positive for ischemic stroke and inverse for hemorrhagic stroke. Aside from hemorrhagic stroke, corresponding associations of cardiovascular disease with sodium and potassium jointly were positive for sodium and inverse for potassium, although some were not statistically significant. Specifically, for coronary heart disease, the hazard ratios for 20% increases were 1.11 (95% CI: 0.95, 1.30) for sodium and 0.85 (95% CI: 0.73, 0.99) for potassium; and corresponding values for heart failure were 1.36 (95% CI: 1.02, 1.82) for sodium and 0.90 (95% CI: 0.69, 1.18) for potassium.
KW - cardiovascular disease
KW - energy consumption
KW - hazard ratio
KW - measurement error
KW - odds ratio
KW - potassium
KW - regression calibration
KW - sodium
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U2 - 10.1093/aje/kwx238
DO - 10.1093/aje/kwx238
M3 - Article
C2 - 28633342
AN - SCOPUS:85034778891
SN - 0002-9262
VL - 186
SP - 1035
EP - 1043
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 9
ER -