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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, and the Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan (MU); Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan (HI); the Department of Food Sciences and Nutrition, Faculty of Human Life and Environment, Nara Women's University, Kitauoyanishi-machi, Nara, Japan (CD); the Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Sciences, Kobe, Japan (AY); Anjo Kosei Hospital, Anjo, Japan (HT); the Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan (YW); the Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan (SK); the Department of Health and Environmental Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan (AK); the Department of Public Health/Health Information Dynamics, Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan (TK); the Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Tokyo, Japan (YI); the Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan (NT); and the Division of Clinical Trials, National Center for Geriatrics and Gerontology, Obu, Japan (AT)
Background: Limited evidence is available about the relations between sodium and potassium intakes and cardiovascular disease in the general population.
Objective: The objective was to investigate relations between sodium and potassium intakes and cardiovascular disease in Asian populations whose mean sodium intake is generally high.
Design: Between 1988 and 1990, a total of 58 730 Japanese subjects (n = 23 119 men and 35 611 women) aged 40–79 y with no history of stroke, coronary heart disease, or cancer completed a lifestyle questionnaire including food intake frequency under the Japan Collaborative Cohort Study for Evaluation of Cancer Risk sponsored by the Ministry of Education, Sports and Science.
Results: After 745 161 person-years of follow-up, we documented 986 deaths from stroke (153 subarachnoid hemorrhages, 227 intraparenchymal hemorrhages, and 510 ischemic strokes) and 424 deaths from coronary heart disease. Sodium intake was positively associated with mortality from total stroke, ischemic stroke, and total cardiovascular disease. The multivariable hazard ratio for the highest versus the lowest quintiles of sodium intake after adjustment for age, sex, and cardiovascular disease risk factors was 1.55 (95% CI: 1.21, 2.00; P for trend < 0.001) for total stroke, 2.04 (95% CI: 1.41, 2.94; P for trend < 0.001) for ischemic stroke, and 1.42 (95% CI: 1.20, 1.69; P for trend < 0.001) for total cardiovascular disease. Potassium intake was inversely associated with mortality from coronary heart disease and total cardiovascular disease. The multivariable hazard ratio for the highest versus the lowest quintiles of potassium intake was 0.65 (95% CI: 0.39, 1.06; P for trend = 0.083) for coronary heart disease and 0.73 (95% CI: 0.59, 0.92; P for trend = 0.018) for total cardiovascular disease, and these associations were more evident for women than for men.
Conclusions: A high sodium intake and a low potassium intake may increase the risk of mortality from cardiovascular disease.
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