Seoul National University College of Medicine, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
BMJ Open. 2021 Dec 20;11(12):e056255. doi: 10.1136/bmjopen-2021-056255.
High salt intake has a harmful effect on hypertension; however, the association between major adverse cardiovascular events (MACE) and salt intake is still controversial. Rheumatoid arthritis (RA) is also characterised by excess cardiovascular risk. However, few studies have investigated the combined role of salt intake and RA in MACE in the general Korean population. Here, we evaluated this relationship among the Korean adult population.
Retrospective, cross-sectional.
Population-based survey in Korea.
This study was based on the data of the seventh Korean National Health and Nutrition Examination Survey (2016-2018). The estimated 24-hour urinary sodium excretion (24HUNa), a surrogate marker for daily sodium intake, was calculated using the Tanaka equation and was stratified into five groups (<3, 3-3.999, 4-4.999, 5-5.999 and ≥6 g/day). Finally, data from 13 464 adult participants (weighted n=90 425 888) were analysed; all analyses considered a complex sampling design. Multivariable logistic regression for MACE as primary dependent variable was performed and adjusted for potential covariates.
Participants with MACE had higher 24HUNa levels and RA proportion than those without MACE (p<0.001). The association of MACE with 24HUNa was J-shaped with a gradual increase from about 3 g/day. The highest 24HUNa (≥6 g/day) group was significantly associated with increased prevalence of MACE compared with the reference group (3-3.999 g/day) after adjusting for all associated covariates (OR 6.75, 95% CI 1.421 to 32.039). In the multivariate logistic regression analysis, RA (OR 2.05, 95% CI 1.283 to 3.264) and the highest 24HUNa group (OR 6.35, 95% CI 1.337 to 30.147) were significantly associated with MACE even after adjusting for baseline covariates.
These nationally representative data suggest that RA and extremely high sodium intake are associated with MACE in the general adult Korean population. Avoiding extremely high salt intake and considering RA as an important risk factor for MACE might help promote public cardiovascular health.
高盐摄入对高血压有不良影响；然而，主要不良心血管事件（MACE）与盐摄入量之间的关系仍存在争议。类风湿关节炎（RA）也具有过度心血管风险的特征。然而，很少有研究调查一般韩国人群中盐摄入量和 RA 对 MACE 的综合作用。在这里，我们评估了韩国成年人群体中的这种关系。
回顾性，横断面研究。
韩国基于人群的调查。
本研究基于第七次韩国国家健康和营养检查调查（2016-2018 年）的数据。使用 Tanaka 方程估算 24 小时尿钠排泄量（24HUNa），这是每日钠摄入量的替代标志物，并分为五组（<3、3-3.999、4-4.999、5-5.999 和≥6 g/天）。最后，对 13464 名成年参与者（加权 n=90425888）的数据进行了分析；所有分析均考虑了复杂的抽样设计。主要依赖变量为 MACE 的多变量逻辑回归，并对潜在协变量进行了调整。
患有 MACE 的参与者的 24HUNa 水平和 RA 比例均高于无 MACE 者（p<0.001）。MACE 与 24HUNa 的关系呈 J 形，约从 3 g/天开始逐渐增加。与参考组（3-3.999 g/天）相比，调整所有相关协变量后，最高 24HUNa（≥6 g/天）组的 MACE 患病率显著升高（OR 6.75，95%CI 1.421 至 32.039）。在多变量逻辑回归分析中，RA（OR 2.05，95%CI 1.283 至 3.264）和最高 24HUNa 组（OR 6.35，95%CI 1.337 至 30.147）与 MACE 显著相关，即使在调整基线协变量后也是如此。
这些具有全国代表性的数据表明，RA 和极高的钠摄入量与韩国一般成年人群的 MACE 有关。避免极高的盐摄入量并将 RA 视为 MACE 的重要危险因素可能有助于促进公众心血管健康。
