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Urinary sodium excr...
Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study
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Mente, A. (författare)
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O'Donnell, M. (författare)
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Rangarajan, S. (författare)
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visa fler...
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McQueen, M. (författare)
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Dagenais, G. (författare)
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Wielgosz, A. (författare)
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Lear, S. (författare)
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Ah, S. T. L. (författare)
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Wei, L. (författare)
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Diaz, R. (författare)
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Avezum, A. (författare)
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Lopez-Jaramillo, P. (författare)
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Lanas, F. (författare)
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Mony, P. (författare)
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Szuba, A. (författare)
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Iqbal, R. (författare)
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Yusuf, R. (författare)
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Mohammadifard, N. (författare)
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Khatib, R. (författare)
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Yusoff, K. (författare)
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Ismail, N. (författare)
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Gulec, S. (författare)
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- Rosengren, Annika, 1951 (författare)
- 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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Yusufali, A. (författare)
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Kruger, L. (författare)
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Tsolekile, L. P. (författare)
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Chifamba, J. (författare)
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Dans, A. (författare)
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Alhabib, K. F. (författare)
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Yeates, K. (författare)
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Teo, K. (författare)
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Yusuf, S. (författare)
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(creator_code:org_t)
- Elsevier BV, 2018
- 2018
- Engelska.
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Ingår i: The Lancet. - : Elsevier BV. - 0140-6736. ; 392:10146, s. 496-506
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background WHO recommends that populations consume less than 2 g/day sodium as a preventive measure against cardiovascular disease, but this target has not been achieved in any country. This recommendation is primarily based on individual-level data from short-term trials of blood pressure (BP) without data relating low sodium intake to reduced cardiovascular events from randomised trials or observational studies. We investigated the associations between community-level mean sodium and potassium intake, cardiovascular disease, and mortality. Methods The Prospective Urban Rural Epidemiology study is ongoing in 21 countries. Here we report an analysis done in 18 countries with data on clinical outcomes. Eligible participants were adults aged 35-70 years without cardiovascular disease, sampled from the general population. We used morning fasting urine to estimate 24 h sodium and potassium excretion as a surrogate for intake. We assessed community-level associations between sodium and potassium intake and BP in 369 communities (all >50 participants) and cardiovascular disease and mortality in 255 communities (all >100 participants), and used individual-level data to adjust for known confounders. Findings 95 767 participants in 369 communities were assessed for BP and 82 544 in 255 communities for cardiovascular outcomes with follow-up for a median of 8.1 years. 82 (80%) of 103 communities in China had a mean sodium intake greater than 5 g/day, whereas in other countries 224 (84%) of 266 communities had a mean intake of 3-5 g/day. Overall, mean systolic BP increased by 2.86 mm Hg per 1 g increase in mean sodium intake, but positive associations were only seen among the communities in the highest tertile of sodium intake (p<0.0001 for heterogeneity). The association between mean sodium intake and major cardiovascular events showed significant deviations from linearity (p=0.043) due to a significant inverse association in the lowest tertile of sodium intake (lowest tertile <4.43 g/day, mean intake 4.04 g/day, range 3.42-4.43; change -1.00 events per 1000 years, 95% CI -2.00 to -0.01, p=0.0497), no association in the middle tertile (middle tertile 4.43-5.08 g/day, mean intake 4.70 g/day, 4.44-5.05; change 0.24 events per 1000 years, -2.12 to 2.61, p=0.8391), and a positive but non-significant association in the highest tertile (highest tertile >5.08 g/day, mean intake 5.75 g/day, >5.08-7.49; change 0.37 events per 1000 years, -0.03 to 0.78, p=0.0712). A strong association was seen with stroke in China (mean sodium intake 5.58 g/day, 0.42 events per 1000 years, 95% CI 0.16 to 0.67, p=0.0020) compared with in other countries (4.49 g/day, -0.26 events, -0.46 to -0.06, p=0.0124; p<0.0001 for heterogeneity). All major cardiovascular outcomes decreased with increasing potassium intake in all countries. Interpretation Sodium intake was associated with cardiovascular disease and strokes only in communities where mean intake was greater than 5 g/day. A strategy of sodium reduction in these communities and countries but not in others might be appropriate. Funding Population Health Research Institute, Canadian Institutes of Health Research, Canadian Institutes of Health Canada Strategy for Patient-Oriented Research, Ontario Ministry of Health and Long-Term Care, Heart and Stroke Foundation of Ontario, and European Research Council. Copyright (c) 2018 Elsevier Ltd. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- low-income countries
- American-Heart-Association
- potassium excretion
- national-health
- hypertension
- salt
- events
- middle
- risk
- reduction
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- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Mente, A.
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O'Donnell, M.
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Rangarajan, S.
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McQueen, M.
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Dagenais, G.
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Wielgosz, A.
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visa fler...
-
Lear, S.
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Ah, S. T. L.
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Wei, L.
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Diaz, R.
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Avezum, A.
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Lopez-Jaramillo, ...
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Lanas, F.
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Mony, P.
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Szuba, A.
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Iqbal, R.
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Yusuf, R.
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Mohammadifard, N ...
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Khatib, R.
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Yusoff, K.
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Ismail, N.
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Gulec, S.
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Rosengren, Annik ...
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Yusufali, A.
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Kruger, L.
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Tsolekile, L. P.
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Chifamba, J.
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Dans, A.
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Alhabib, K. F.
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Yeates, K.
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Teo, K.
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Yusuf, S.
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Hälsovetenskap
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och Folkhälsovetensk ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
- Artiklar i publikationen
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The Lancet
- Av lärosätet
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Göteborgs universitet