Department of Radiology, University of Washington, Seattle, WA, USA.
Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# Zhongshan North Road, Nanjing, Jiangsu, China.
Eur J Nutr. 2021 Dec;60(8):4555-4563. doi: 10.1007/s00394-021-02612-1. Epub 2021 Jun 19.
Dietary sodium and potassium intake are associated with stroke, but the potential mechanisms are unclear. We aimed to study the association between sodium and potassium intake and subclinical cerebrovascular health in hypertensive older males using multimodal magnetic resonance imaging.
A total of 189 hypertensive male subjects without previous cardiovascular or cerebrovascular disease were included. Daily urinary sodium and potassium excretion were estimated from a fasting spot urine sample using a formula approach. A dedicated cerebrovascular health imaging protocol including vessel wall imaging, angiography, arterial spin labeling imaging and T2-weighted fluid-attenuated inversion recovery imaging was performed to study intracranial atherosclerosis, vascular rarefaction (defined as fewer discernible vessels on angiography), brain perfusion and small vessel disease, respectively.
The mean age was 64.9 (± 7.2) years. The average daily urinary and potassium excretion was 4.7 (± 1.4) g/L and 2.1 (± 0.5) g/L, respectively. Increased urinary sodium excretion was associated with decreased cerebral blood flow and elevated urinary potassium excretion was associated with reduced prevalence of intracranial plaque. The associations remained significant after adjusting for covariates, even including blood pressure control. Quadratic regression analysis indicated a marginally significant U-shaped association between urinary sodium intake and white matter hyperintensity, which lost significance in fully adjusted models. No significant association of urinary sodium and potassium excretion with other cerebrovascular health measures was noted.
We concluded that in hypertensive older males without overt cardiovascular disease, increased sodium intake and reduced potassium intake are associated with impaired subclinical cerebrovascular health.
钠和钾的饮食摄入量与中风有关，但潜在的机制尚不清楚。我们旨在使用多模态磁共振成像研究钠和钾摄入量与高血压老年男性亚临床脑血管健康之间的关系。
共纳入 189 名无既往心血管或脑血管疾病的高血压男性患者。使用公式法从空腹尿液样本中估算每日尿钠和钾排泄量。进行专门的脑血管健康成像方案，包括血管壁成像、血管造影、动脉自旋标记成像和 T2 加权液体衰减反转恢复成像，分别研究颅内动脉粥样硬化、血管稀疏（定义为血管造影上可识别的血管较少）、脑灌注和小血管疾病。
平均年龄为 64.9（±7.2）岁。平均每日尿钠和钾排泄量分别为 4.7（±1.4）g/L 和 2.1（±0.5）g/L。尿钠排泄量增加与脑血流减少有关，而尿钾排泄量增加与颅内斑块减少有关。即使包括血压控制在内，调整了协变量后，这些关联仍然显著。二次回归分析表明，尿钠摄入量与脑白质高信号之间存在边际显著的 U 形关联，但在完全调整模型中失去了显著性。未发现尿钠和钾排泄与其他脑血管健康测量指标之间存在显著关联。
我们得出结论，在无明显心血管疾病的高血压老年男性中，钠摄入量增加和钾摄入量减少与亚临床脑血管健康受损有关。
