饮食中钠和钾的摄入量与心血管疾病死亡率之间的关系：日本癌症风险评估协作队列研究

Relations between dietary sodium and potassium intakes and mortality from cardiovascular disease: the Japan Collaborative Cohort Study for Evaluation of Cancer Risks.

作者信息

Umesawa Mitsumasa, Iso Hiroyasu, Date Chigusa, Yamamoto Akio, Toyoshima Hideaki, Watanabe Yoshiyuki, Kikuchi Shogo, Koizumi Akio, Kondo Takaaki, Inaba Yutaka, Tanabe Naohito, Tamakoshi Akiko

机构信息

Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, and the Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan.

出版信息

Am J Clin Nutr. 2008 Jul;88(1):195-202. doi: 10.1093/ajcn/88.1.195.

DOI:10.1093/ajcn/88.1.195

PMID:18614741

Abstract

BACKGROUND

Limited evidence is available about the relations between sodium and potassium intakes and cardiovascular disease in the general population.

OBJECTIVE

The objective was to investigate relations between sodium and potassium intakes and cardiovascular disease in Asian populations whose mean sodium intake is generally high.

DESIGN

Between 1988 and 1990, a total of 58,730 Japanese subjects (n = 23,119 men and 35,611 women) aged 40-79 y with no history of stroke, coronary heart disease, or cancer completed a lifestyle questionnaire including food intake frequency under the Japan Collaborative Cohort Study for Evaluation of Cancer Risk sponsored by the Ministry of Education, Sports and Science.

RESULTS

After 745,161 person-years of follow-up, we documented 986 deaths from stroke (153 subarachnoid hemorrhages, 227 intraparenchymal hemorrhages, and 510 ischemic strokes) and 424 deaths from coronary heart disease. Sodium intake was positively associated with mortality from total stroke, ischemic stroke, and total cardiovascular disease. The multivariable hazard ratio for the highest versus the lowest quintiles of sodium intake after adjustment for age, sex, and cardiovascular disease risk factors was 1.55 (95% CI: 1.21, 2.00; P for trend < 0.001) for total stroke, 2.04 (95% CI: 1.41, 2.94; P for trend < 0.001) for ischemic stroke, and 1.42 (95% CI: 1.20, 1.69; P for trend < 0.001) for total cardiovascular disease. Potassium intake was inversely associated with mortality from coronary heart disease and total cardiovascular disease. The multivariable hazard ratio for the highest versus the lowest quintiles of potassium intake was 0.65 (95% CI: 0.39, 1.06; P for trend = 0.083) for coronary heart disease and 0.73 (95% CI: 0.59, 0.92; P for trend = 0.018) for total cardiovascular disease, and these associations were more evident for women than for men.

CONCLUSIONS

A high sodium intake and a low potassium intake may increase the risk of mortality from cardiovascular disease.

摘要

背景

关于一般人群中钠和钾摄入量与心血管疾病之间的关系，现有证据有限。

目的

旨在调查钠和钾摄入量与亚洲人群心血管疾病之间的关系，亚洲人群的钠平均摄入量普遍较高。

设计

在1988年至1990年期间，共有58730名年龄在40 - 79岁、无中风、冠心病或癌症病史的日本受试者（男性23119名，女性35611名），在文部科学省赞助的日本癌症风险评估协作队列研究中完成了一份生活方式问卷，其中包括食物摄入频率。

结果

经过745161人年的随访，我们记录了986例中风死亡（153例蛛网膜下腔出血、227例脑实质内出血和510例缺血性中风）以及424例冠心病死亡。钠摄入量与总中风、缺血性中风和总心血管疾病的死亡率呈正相关。在调整年龄、性别和心血管疾病风险因素后，钠摄入量最高五分位数与最低五分位数相比，总中风的多变量风险比为1.55（95%置信区间：1.21, 2.00；趋势P < 0.001），缺血性中风为2.04（95%置信区间：1.41, 2.94；趋势P < 0.001），总心血管疾病为1.42（95%置信区间：1.20, 1.69；趋势P < 0.001）。钾摄入量与冠心病和总心血管疾病的死亡率呈负相关。钾摄入量最高五分位数与最低五分位数相比，冠心病的多变量风险比为0.65（95%置信区间：0.39, 1.06；趋势P = 0.083），总心血管疾病为0.73（95%置信区间：0.59, 0.92；趋势P = 0.018），这些关联在女性中比在男性中更明显。