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).
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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 small-cubic-spline patch of your own relationship between estimated 24-hr urinary salt removal and chemical result of passing regarding people result in and you may major free island chat room cardiovascular incidents. The brand new spline bend is actually truncated on grams everyday (experiences rate certainly one of players with sodium excretion > g a day, 8 situations from inside the 305 users). Committee B reveals a limited-cubic-spline area of your organization anywhere between projected salt removal and you can passing. The function speed among members which have salt excretion of greater than grams a-day was 5 incidents into the 305 people. Panel C shows a limited-cubic-spline plot of association anywhere between estimated sodium excretion and big cardio events (defined as dying away from aerobic explanations, myocardial infarction, coronary attack, or cardiovascular system incapacity). The big event speed among professionals having salt excretion of greater than g per day are 6 situations inside the 305 members. Every plots of land was basically adjusted to have many years, intercourse, geographical area, informative height, ancestry (Western versus. non-Asian), alcohol intake, body-mass index, and you will standing with respect to diabetes mellitus, reputation of cardiovascular situations, and you may newest puffing. Dashed lines imply 95% rely on intervals. The new average sodium removal (4.72 grams every single day) are the latest source important, conveyed of the purple range. To transform the values getting projected salt excretion to help you sodium consumption in the g every single day, proliferate by 2.5.
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As compared with an estimated sodium excretion out-of cuatro.00 so you can 5.99 g daily (the fresh new source category), projected excretion from 7.00 grams just about every day or higher was associated with the improved threats of your number 1 composite result (potential ratio, step 1.15; 95% confidence period [CI], 1.02 to one.30), demise regarding people cause (chances ratio, 1.25; 95% CI, step one.07 to one.48), a major cardio knowledge (chances ratio, 1.16; 95% CI, 1.01 to just one.34), demise regarding aerobic factors (potential proportion, 1.54; 95% CI, 1.21 to one.95), and you can heart attack ultimately causing death or hospitalization (potential ratio, 1.29; 95% CI, 1.02 to at least one.63) towards multivariable analysis ( Table 2 and you can Figure step 1 , and you will Desk S2 on the Additional Appendix). The association between a high estimated sodium removal (?eight.00 grams a day) and also the first mixture result, significant aerobic incidents, and you may coronary attack leading to passing or hospitalization is actually attenuated and you will is actually not any longer high shortly after adjustment having hypertension or earlier in the day diagnosis away from blood pressure however, stayed tall getting demise out of one trigger ( Desk dos , and you will Desk S2 regarding the Additional Appendix).