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Publications

Journal Article Epublish

PubMed: 42770126 DOI: 10.4103/ijpvm.ijpvm_303_25

Association Between Estimated 24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk and Events: Findings from the Isfahan Cohort Study.

Int J Prev Med 17:69

Authors: Masoumeh Sadeghi, Fereshteh Sattar, Mohammad Karami, Mohammad Talaei, Hamidreza Roohafza, Sina Fadaei Tehrani, Ehsan Shirvani, Mohammad Hadi Mansouri, Marzieh Taheri, Nizal Sarrafzadegan

Affiliations

  • Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Institute of Population Health Sciences, Barts and the London School of Medicine, Queen Mary University of London, UK.
  • Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

BACKGROUND

Sodium and potassium intake are key determinants of cardiovascular (CV) health, largely through effects on blood pressure. Most studies have focused on serum levels or dietary estimates, with limited evidence linking urinary excretion to CV outcomes.

OBJECTIVE

To examine associations between estimated 24-hour urinary sodium and potassium excretion and cardiovascular risk factors and events in Iranian adults.

METHODS

In this historical cohort study, 1,953 participants from the Isfahan Cohort Study with random morning urine samples (2013) and two-year follow-up were included. Sodium and potassium excretion were estimated using the Tanaka formula. Cox proportional hazards models assessed associations between tertiles of excretion and incident CV events, adjusting for demographic, clinical, lifestyle, and medication variables.

RESULTS

Higher sodium excretion was associated with male sex, higher BMI, blood pressure, plasma sodium and potassium, better dietary quality (lower global dietary index score), and greater physical activity. Higher potassium excretion was associated with younger age, male sex, higher BMI and triglycerides, higher plasma electrolytes, lower smoking prevalence, and higher diabetes prevalence. No significant associations were observed between sodium or potassium excretion and CV events in adjusted models. Hazard ratios for higher sodium tertiles were consistently > 1.0, suggesting a nonsignificant trend toward increased risk. Potassium excretion showed a nonlinear pattern, with the middle tertile having the highest hazard ratio.

CONCLUSIONS

Estimated urinary sodium and potassium excretion were linked to several cardiometabolic risk factors but not to short-term CV events. Longer follow-up and more accurate intake assessments are needed to clarify their role in CV risk prediction.

MeSH

Blood, Blood Pressure, Cohort Studies, Prevalence, Sex, Risk Factors, Plasma