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Urinary Sodium and ...
Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study
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Judge, C. (author)
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O'Donnell, M. J. (author)
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Hankey, G. J. (author)
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Rangarajan, S. (author)
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Chin, S. L. (author)
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Rao-Melacini, P. (author)
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Ferguson, J. (author)
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Smyth, A. (author)
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Xavier, D. (author)
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Liu, L. S. (author)
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Zhang, H. Y. (author)
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Lopez-Jaramillo, P. (author)
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Damasceno, A. (author)
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Langhorne, P. (author)
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- Rosengren, Annika, 1951 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Dans, A. L. (author)
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Elsayed, A. (author)
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Avezum, A. (author)
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Mondo, C. (author)
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Ryglewicz, D. (author)
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Czlonkowska, A. (author)
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Pogosova, N. (author)
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Weimar, C. (author)
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Diaz, R. (author)
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Yusoff, K. (author)
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Yusufali, A. (author)
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Oguz, A. (author)
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Wang, X. Y. (author)
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Lanas, F. (author)
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Ogah, O. S. (author)
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Ogunniyi, A. (author)
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Iversen, H. K. (author)
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Malaga, G. (author)
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Rumboldt, Z. (author)
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Oveisgharan, S. (author)
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Al Hussain, F. (author)
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Yusuf, S. (author)
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Interstroke Investigators, Interstroke Investigators (author)
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(creator_code:org_t)
- 2020-11-16
- 2021
- English.
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In: American Journal of Hypertension. - : Oxford University Press (OUP). - 0895-7061 .- 1941-7225. ; 34:4, s. 414-425
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https://academic.oup...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND Although low sodium intake (<2 g/day) and high potassium intake (>3.5 g/day) are proposed as public health interventions to reduce stroke risk, there is uncertainty about the benefit and feasibility of this combined recommendation on prevention of stroke. METHODS We obtained random urine samples from 9,275 cases of acute first stroke and 9,726 matched controls from 27 countries and estimated the 24-hour sodium and potassium excretion, a surrogate for intake, using the Tanaka formula. Using multivariable conditional logistic regression, we determined the associations of estimated 24-hour urinary sodium and potassium excretion with stroke and its subtypes. RESULTS Compared with an estimated urinary sodium excretion of 2.8-3.5 g/ day (reference), higher (>4.26 g/day) (odds ratio [OR] 1.81; 95% confidence interval [CI], 1.65-2.00) and lower (<2.8 g/day) sodium excretion (OR 1.39; 95% CI, 1.26-1.53) were significantly associated with increased risk of stroke. The stroke risk associated with the highest quartile of sodium intake (sodium excretion >4.26 g/day) was significantly greater (P < 0.001) for intracerebral hemorrhage (ICH) (OR 2.38; 95% CI, 1.93-2.92) than for ischemic stroke (OR 1.67; 95% CI, 1.50-1.87). Urinary potassium was inversely and linearly associated with risk of stroke, and stronger for ischemic stroke than ICH (P = 0.026). In an analysis of combined sodium and potassium excretion, the combination of high potassium intake (>1.58 g/day) and moderate sodium intake (2.8-3.5 g/day) was associated with the lowest risk of stroke. CONCLUSIONS The association of sodium intake and stroke is J-shaped, with high sodium intake a stronger risk factor for ICH than ischemic stroke. Our data suggest that moderate sodium intake-rather than low sodium intake-combined with high potassium intake may be associated with the lowest risk of stroke and expected to be a more feasible combined dietary target.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- blood pressure
- hypertension
- intracerebral hemorrhage
- ischemic stroke
- potassium
- sodium
- stroke
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Judge, C.
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O'Donnell, M. J.
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Hankey, G. J.
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Rangarajan, S.
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Chin, S. L.
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Rao-Melacini, P.
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show more...
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Ferguson, J.
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Smyth, A.
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Xavier, D.
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Liu, L. S.
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Zhang, H. Y.
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Lopez-Jaramillo, ...
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Damasceno, A.
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Langhorne, P.
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Rosengren, Annik ...
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Dans, A. L.
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Elsayed, A.
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Avezum, A.
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Mondo, C.
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Ryglewicz, D.
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Czlonkowska, A.
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Pogosova, N.
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Weimar, C.
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Diaz, R.
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Yusoff, K.
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Yusufali, A.
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Oguz, A.
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Wang, X. Y.
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Lanas, F.
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Ogah, O. S.
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Ogunniyi, A.
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Iversen, H. K.
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Malaga, G.
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Rumboldt, Z.
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Oveisgharan, S.
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Al Hussain, F.
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Yusuf, S.
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Interstroke Inve ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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American Journal ...
- By the university
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University of Gothenburg