Yang Quanhe, Liu Tiebin, Kuklina Elena V, Flanders W Dana, Hong Yuling, Gillespie Cathleen, Chang Man-Huei, Gwinn Marta, Dowling Nicole, Khoury Muin J, Hu Frank B
Division for Heart Diseases and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mail Stop K-47, Atlanta, GA 30341, USA.
Arch Intern Med. 2011 Jul 11;171(13):1183-91. doi: 10.1001/archinternmed.2011.257.
Several epidemiologic studies suggested that higher sodium and lower potassium intakes were associated with increased risk of cardiovascular diseases (CVD). Few studies have examined joint effects of dietary sodium and potassium intake on risk of mortality.
To investigate estimated usual intakes of sodium and potassium as well as their ratio in relation to risk of all-cause and CVD mortality, the Third National Health and Nutrition Examination Survey Linked Mortality File (1988-2006), a prospective cohort study of a nationally representative sample of 12,267 US adults, studied all-cause, cardiovascular, and ischemic heart (IHD) diseases mortality.
During a mean follow-up period of 14.8 years, we documented a total of 2270 deaths, including 825 CVD deaths and 443 IHD deaths. After multivariable adjustment, higher sodium intake was associated with increased all-cause mortality (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.03-1.41 per 1000 mg/d), whereas higher potassium intake was associated with lower mortality risk (HR, 0.80; 95% CI, 0.67-0.94 per 1000 mg/d). For sodium-potassium ratio, the adjusted HRs comparing the highest quartile with the lowest quartile were HR, 1.46 (95% CI, 1.27-1.67) for all-cause mortality; HR, 1.46 (95% CI, 1.11-1.92) for CVD mortality; and HR, 2.15 (95% CI, 1.48-3.12) for IHD mortality. These findings did not differ significantly by sex, race/ethnicity, body mass index, hypertension status, education levels, or physical activity.
Our findings suggest that a higher sodium-potassium ratio is associated with significantly increased risk of CVD and all-cause mortality, and higher sodium intake is associated with increased total mortality in the general US population.
多项流行病学研究表明，较高的钠摄入量和较低的钾摄入量与心血管疾病（CVD）风险增加有关。很少有研究考察饮食中钠和钾摄入量对死亡风险的联合影响。
为了调查钠和钾的估计通常摄入量及其比值与全因死亡率和CVD死亡率风险的关系，利用第三次全国健康和营养检查调查关联死亡率文件（1988 - 2006年），这是一项对12267名美国成年人的全国代表性样本进行的前瞻性队列研究，研究了全因、心血管和缺血性心脏病（IHD）死亡率。
在平均14.8年的随访期内，我们共记录了2270例死亡，包括825例CVD死亡和443例IHD死亡。多变量调整后，较高的钠摄入量与全因死亡率增加相关（风险比[HR]，1.20；95%置信区间[CI]，每1000 mg/d为1.03 - 1.41），而较高的钾摄入量与较低的死亡风险相关（HR，0.80；95% CI，每1000 mg/d为0.67 - 0.94）。对于钠钾比值，将最高四分位数与最低四分位数进行比较的调整后HRs为：全因死亡率HR，1.46（95% CI，1.27 - 1.67）；CVD死亡率HR，1.46（95% CI，1.11 - 1.92）；IHD死亡率HR，2.15（95% CI，1.48 - 3.12）。这些结果在性别、种族/民族、体重指数、高血压状态、教育水平或身体活动方面没有显著差异。
我们的研究结果表明，较高的钠钾比值与CVD和全因死亡率风险显著增加相关，较高的钠摄入量与美国普通人群的总死亡率增加相关。
