To further explore the potential effect of imbalanced confounders, we performed propensity-score–matched sensitivity analyses 30 that compared a high estimated sodium excretion (?6.00 g per day) with a moderate level (3.00 to 5.99 g per day) and that compared a low estimated sodium excretion (<3.00 g per day) with the moderate level. In a secondary analysis, we examined the association between an estimated “usual” level of sodium or potassium excretion and death and cardiovascular disease, with correction for regression dilution bias (with the use of repeated measurements in 448 participants). 31 All analyses were conducted with the use of SAS software, version 9.2, for the UNIX operating system (SAS Institute).
The study included 101,945 participants, 42% of whom were from China. The mean estimated 24-hour sodium excretion was 4.93 g, and the mean estimated 24-hour potassium excretion was 2.12 g ( Table 1 , and Table S1 in the Supplementary Appendix). The mean systolic and diastolic blood pressures were higher among participants with a higher estimated sodium excretion (P<0.001). The mean duration of follow-up was 3.7 years, with follow-up completed for 95% of the participants. The primary composite outcome of death or a major cardiovascular event occurred in 3317 participants (3.3%): 1976 participants died (650 from cardiovascular causes), 857 had myocardial infarction, 872 had stroke, and 261 had heart failure. Participants may have had more than one cardiovascular event.
Panel A reports a finite-cubic-spline patch of your association anywhere between estimated twenty four-hr urinary salt excretion and substance outcome of passing of any trigger and biggest cardio incidents. The fresh spline contour are truncated from the grams everyday (skills rate certainly one of people which have sodium removal > grams just about every day, 8 situations inside the 305 participants). Panel B suggests a limited-cubic-spline area of your own relationship ranging from projected sodium removal and you can death. The event rate certainly one of members with salt excretion greater than g everyday is 5 occurrences into the 305 participants. Panel C shows a finite-cubic-spline area of your own relationship anywhere between projected salt excretion and you can significant cardiovascular events (recognized as death regarding cardiovascular reasons, myocardial infarction, stroke, or center inability). The big event rates among professionals with salt removal of greater than grams a day was six incidents during the 305 players. All the plots of land was indeed modified getting age, gender, geographical region, academic height, ancestry (Far eastern versus. non-Asian), alcoholic beverages intake, body-bulk list, and you will standing with regards to diabetes mellitus, reputation of cardio incidents, and you can most recent smoking. Dashed traces suggest 95% count on menstruation. New average salt excretion (cuatro.72 g on a daily basis) is actually new reference simple, conveyed from the yellow range. To alter the costs to own projected salt removal so you’re able to sodium consumption inside the g every single day, multiply from the dos.5.
Than an estimated sodium removal away from cuatro.00 to 5.99 grams daily (the new resource group), projected removal from seven.00 g each day or maybe more is in the enhanced risks of your own no. 1 chemical result (chances ratio, step one.15; 95% depend on period [CI], step one.02 to just one.30), demise out of people cause (odds proportion, step 1.25; 95% CI, step one.07 to one.48), a primary aerobic event (possibility ratio, step 1.16; 95% CI, 1.01 to 1.34), demise out-of aerobic causes (potential ratio, 1.54; 95% CI, step one.21 to at least one.95), and coronary attack ultimately causing passing or hospitalization (opportunity ratio, step 1.29; 95% CI, step 1.02 to one.63) towards multivariable research ( Dining table 2 and you can Profile 1 , and you can Table S2 on the Supplementary Appendix). Brand new connection anywhere between a top projected sodium removal (?7.00 grams a-day) in addition to primary compound consequences, 100 free italian dating sites big aerobic occurrences, and you can stroke resulting in dying or hospitalization was attenuated and you may is actually no further high immediately following changes to have blood circulation pressure otherwise past medical diagnosis out-of blood circulation pressure but stayed high to own demise regarding one lead to ( Desk dos , and you may Dining table S2 on Second Appendix).
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