JAMA：评估尿钠排泄和心血管事件关系的研究

Urinary Sodium and Potassium Excretion and Risk of Cardiovascular Events

Martin J. O'Donnell, MB, PhD; Salim Yusuf, DPhil, FRCPC, FRSC; Andrew Mente, PhD; Peggy Gao, MSc; Johannes F. Mann, MD; Koon Teo, MB, PhD; Matthew McQueen, MD; Peter Sleight, MD; Arya M. Sharma, MD; Antonio Dans, MD; Jeffrey Probstfield, MD; Roland E. Schmieder, MD

The precise relationship between sodium and potassium intake and cardiovascular (CV) risk remains uncertain, especially in patients with CV disease. To determine the association between estimated urinary sodium and potassium excretion (surrogates for intake) and CV events in patients with established CV disease or diabetes mellitus. Observational analyses of 2 cohorts (N = 28 880) included in the ONTARGET and TRANSCEND trials (November 2001-March 2008 from initial recruitment to final follow-up). We estimated 24-hour urinary sodium and potassium excretion from a morning fasting urine sample (Kawasaki formula). We used restricted cubic spline plots to describe the association between sodium and potassium excretion and CV events and mortality, and to identify reference categories for sodium and potassium excretion. We used Cox proportional hazards multivariable models to determine the association of urinary sodium and potassium with CV events and mortality.