Rabinowitz Jonathan, Darawshi Mahmoud, Burak Nuriel, Boehm Manfred, Dmitrieva Natalia I
medRxiv. 2024 Jul 15:2024.07.05.24309996. doi: 10.1101/2024.07.05.24309996.
Population aging is fueling an epidemic of age-related chronic diseases. Managing risk factors and lifestyle interventions have proven effective in disease prevention. Epidemiological studies have linked markers of poor hydration with higher risk of chronic diseases and premature mortality. Many individuals do not adhere to recommended hydration levels and could benefit from improved hydration habits. Our study evaluates the use of electronic medical records to confirm the relationship between inadequate hydration and the risk of chronic diseases, which may inform hydration-focused interventions in general healthcare.
We analyzed 20-year electronic medical records for 411,029 adults from Israel's Leumit Healthcare Services. Hydration status was assessed using serum sodium and tonicity. We included adults without significant chronic diseases or water balance issues, defined as having normal serum sodium (135-146 mmol/l) and no diagnosis of diabetes. We used Cox proportional hazards models, adjusted for age, to assess the risk of developing hypertension and heart failure.
Our findings showed an increased risk of hypertension with elevated serum sodium levels: a 12% rise for the 140-142 mmol/l group and 30% for levels above 143 mmol/l (HR1.30, 95%CI:1.26-1.34). Tonicity over 287 mosmol/kg was associated with a 19% increased risk of hypertension (HR1.19, 95%CI:1.17-1.22). The risk of heart failure also increased, reaching 20% for sodium levels above 143 mmol/l (HR1.20,95%CI:1.12-1.29) and 16% for tonicity above 289 mosmol/kg (HR1.16, 95%CI: 1.10-1.22). The association between sodium and hypertension was observed across genders, while the risk of heart failure was more pronounced in females. Within the healthy Leumit cohort, 19% had serum sodium levels within the 143-146 mmol/l range, and 39% were in the 140-142 mmol/l range.
Data analysis from electronic medical records identified a link between serum sodium of 140 mmol/l and above and increased risk of hypertension and heart failure in the general Israeli population. Identifying individuals with high-normal sodium values in healthcare records could guide improvements in hydration habits, potentially leading to better health outcomes.
人口老龄化正推动与年龄相关的慢性疾病流行。控制风险因素和进行生活方式干预已被证明在疾病预防中有效。流行病学研究已将水分摄入不足的指标与更高的慢性疾病风险和过早死亡风险联系起来。许多人未遵循推荐的水分摄入水平，改善水分摄入习惯可能会使他们受益。我们的研究评估了利用电子病历确认水分摄入不足与慢性疾病风险之间的关系，这可能为一般医疗保健中以水合作用为重点的干预措施提供依据。
我们分析了以色列Leumit医疗服务机构411,029名成年人的20年电子病历。使用血清钠和渗透压评估水合状态。我们纳入了没有重大慢性疾病或水平衡问题的成年人，定义为血清钠正常（135 - 146 mmol/L）且未诊断出糖尿病。我们使用Cox比例风险模型，并对年龄进行了调整，以评估患高血压和心力衰竭的风险。
我们的研究结果显示，血清钠水平升高会增加患高血压的风险：140 - 142 mmol/L组风险上升12%，高于143 mmol/L组风险上升30%（风险比1.30，95%置信区间：1.26 - 1.34）。渗透压超过287 mosmol/kg与高血压风险增加19%相关（风险比1.19，95%置信区间：1.17 - 1.22）。心力衰竭风险也增加，血清钠水平高于143 mmol/L时风险达到20%（风险比1.20，95%置信区间：1.12 - 1.29），渗透压高于289 mosmol/kg时风险为16%（风险比1.16，95%置信区间：1.10 - 1.22）。钠与高血压之间的关联在各性别中均有观察到，而心力衰竭风险在女性中更为明显。在健康的Leumit队列中，19%的人的血清钠水平在143 - 146 mmol/L范围内，39%的人在140 - 142 mmol/L范围内。
电子病历数据分析确定了以色列普通人群中血清钠140 mmol/L及以上与高血压和心力衰竭风险增加之间的联系。在医疗记录中识别出高正常钠值的个体可以指导水分摄入习惯的改善，可能会带来更好的健康结果。
