Universidad Peruana Cayetano Heredia

Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study.

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dc.contributor.author Judge, Conor
dc.contributor.author O'Donnell, Martin J.
dc.contributor.author Hankey, Graeme J.
dc.contributor.author Rangarajan, Sumathy
dc.contributor.author Chin, Siu Lim
dc.contributor.author Rao-Melacini, Purnima
dc.contributor.author Ferguson, John
dc.contributor.author Smyth, Andrew
dc.contributor.author Xavier, Denis
dc.contributor.author Lisheng, Liu
dc.contributor.author Zhang, Hongye
dc.contributor.author Lopez-Jaramillo, Patricio
dc.contributor.author Damasceno, Albertino
dc.contributor.author Langhorne, Peter
dc.contributor.author Rosengren, Annika
dc.contributor.author Dans, Antonio L.
dc.contributor.author Elsayed, Ahmed
dc.contributor.author Avezum, Alvaro
dc.contributor.author Mondo, Charles
dc.contributor.author Ryglewicz, Danuta
dc.contributor.author Czlonkowska, Anna
dc.contributor.author Pogosova, Nana
dc.contributor.author Weimar, Christian
dc.contributor.author Diaz, Rafael
dc.contributor.author Yusoff, Khalid
dc.contributor.author Yusufali, Afzalhussein
dc.contributor.author Oguz, Aytekin
dc.contributor.author Wang, Xingyu
dc.contributor.author Lanas, Fernando
dc.contributor.author Ogah, Okechukwu S.
dc.contributor.author Ogunniyi, Adesola
dc.contributor.author Iversen, Helle K.
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Rumboldt, Zvonko
dc.contributor.author Oveisgharan, Shahram
dc.contributor.author Al Hussain, Fawaz
dc.contributor.author Yusuf, Salim
dc.date.accessioned 2021-05-18T21:44:17Z
dc.date.available 2021-05-18T21:44:17Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9410
dc.description.abstract 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 en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries American Journal of Hypertension
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject blood pressure en_US
dc.subject hypertension en_US
dc.subject intracerebral hemorrhage en_US
dc.subject ischemic stroke en_US
dc.subject potassium en_US
dc.subject sodium en_US
dc.subject stroke en_US
dc.title Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/ajh/hpaa176
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.27
dc.relation.issn 1941-7225


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