Key result
Dietary sodium intake exhibits a J-shaped association with cardiovascular mortality, with increased risk at low (<2 g/day; HR 1.37, P=0.03) and high (>4 g/day) levels of average intake.
Why the study?
Does dietary sodium restriction reduce cardiovascular disease mortality and morbidity?
Does dietary sodium restriction reduce cardiovascular disease mortality and morbidity?
Hazard Ratio: 1.37
p-value: p=0.03
The relationship between sodium intake and cardiovascular mortality appears J-shaped, suggesting that universal severe sodium restriction may not be beneficial and could be harmful.
Cautions against sodium <2 g/day; leaves open optimal targets for randomized trials.
PURPOSE OF REVIEW: Persistent recommendations for universal restriction of dietary sodium intake are based on associations of sodium intake with blood pressure. No clinical trial data support an association of sodium intake with mortality and morbidity outcomes, however, while results of observational studies appear heterogeneous. Can these contradictory data be reconciled to inform health policy regarding sodium intake recommendations? RECENT FINDINGS: We reported (2006) a statistically significant (P = 0.03) association of sodium intake less than 2.3 g/day with increased cardiovascular disease mortality (hazard ratio 1.37) in a representative sample of the US adult population with an observed baseline mean sodium intake of 2.7 g/day. Others reported (2004) a significant (P < 0.01) higher stroke death among males and borderline significant (P = 0.07) for females, for highest compared with lowest sodium tertile in a community in Japan with mean intake of 5.4 g/day. SUMMARY: These results are consistent with earlier studies suggesting that the association of sodium with morbidity and mortality in industrial societies follows a 'J shape' with a direct association at high levels of average intake (over 4 g), an inverse association at lower levels (less than 2 g) and no measurable effect for the widely prevalent intakes in between.
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Cohen et al. (2007) conducted a review in Cardiovascular disease. Dietary sodium intake was evaluated on Cardiovascular disease mortality (HR 1.37, p=0.03). Dietary sodium intake exhibits a J-shaped association with cardiovascular mortality, with increased risk at low (<2 g/day; HR 1.37, P=0.03) and high (>4 g/day) levels of average intake.
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