{"id":21141,"date":"2022-03-17T05:18:00","date_gmt":"2022-03-16T21:18:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21141"},"modified":"2022-03-17T06:00:27","modified_gmt":"2022-03-16T22:00:27","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a24%e5%b0%8f%e6%97%b6%e5%b0%bf%e9%92%a0%e4%b8%8e%e5%b0%bf%e9%92%be%e6%8e%92%e6%b3%84%e4%b8%8e%e5%bf%83%e8%a1%80%e7%ae%a1%e7%97%85%e9%a3%8e%e9%99%a9","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21141","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a24\u5c0f\u65f6\u5c3f\u94a0\u4e0e\u5c3f\u94be\u6392\u6cc4\u4e0e\u5fc3\u8840\u7ba1\u75c5\u98ce\u9669"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/medical-articles\/original-article\" class=\"\">ORIGINAL ARTICLE<\/a><strong>FREE PREVIEW<\/strong><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Yuan Ma, Feng J. He, Qi Sun,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med 2022; 386:252-263<br \/>DOI: 10.1056\/NEJMoa2109794<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">BACKGROUND<\/h3>\n\n\n\n<p>The relation between sodium intake and cardiovascular disease remains controversial, owing in part to inaccurate assessment of sodium intake. Assessing 24-hour urinary excretion over a period of multiple days is considered to be an accurate method.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">METHODS<\/h3>\n\n\n\n<p>We included individual-participant data from six prospective cohorts of generally healthy adults; sodium and potassium excretion was assessed with the use of at least two 24-hour urine samples per participant. The primary outcome was a cardiovascular event (coronary revascularization or fatal or nonfatal myocardial infarction or stroke). We analyzed each cohort using consistent methods and combined the results using a random-effects meta-analysis.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">RESULTS<\/h3>\n\n\n\n<p>Among 10,709 participants, who had a mean (\u00b1SD) age of 51.5\u00b112.6 years and of whom 54.2% were women, 571 cardiovascular events were ascertained during a median study follow-up of 8.8 years (incidence rate, 5.9 per 1000 person-years). The median 24-hour urinary sodium excretion was 3270 mg (10th to 90th percentile, 2099 to 4899). Higher sodium excretion, lower potassium excretion, and a higher sodium-to-potassium ratio were all associated with a higher cardiovascular risk in analyses that were controlled for confounding factors (P\u22640.005 for all comparisons). In analyses that compared quartile 4 of the urinary biomarker (highest) with quartile 1 (lowest), the hazard ratios were 1.60 (95% confidence interval [CI], 1.19 to 2.14) for sodium excretion, 0.69 (95% CI, 0.51 to 0.91) for potassium excretion, and 1.62 (95% CI, 1.25 to 2.10) for the sodium-to-potassium ratio. Each daily increment of 1000 mg in sodium excretion was associated with an 18% increase in cardiovascular risk (hazard ratio, 1.18; 95% CI, 1.08 to 1.29), and each daily increment of 1000 mg in potassium excretion was associated with an 18% decrease in risk (hazard ratio, 0.82; 95% CI, 0.72 to 0.94).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">CONCLUSIONS<\/h3>\n\n\n\n<p>Higher sodium and lower potassium intakes, as measured in multiple 24-hour urine samples, were associated in a dose\u2013response manner with a higher cardiovascular risk. These findings may support reducing sodium intake and increasing potassium intake from current levels. (Funded by the American Heart Association and the National Institutes of Health.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ORIGINAL ARTICLEFREE PREVIEW 24-Hour Urinary Sodium and [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21141"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21141"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21141\/revisions"}],"predecessor-version":[{"id":21142,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21141\/revisions\/21142"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21141"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21141"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}