Cardiovascular risk associated with sodium-containing medicines

INTRODUCTION: It is widely recognized that excess sodium intake increases the risk of hypertension, and this subsequently increases the risk of cardiovascular disease. Although efforts are being made to reduce sodium intake in the population in general, there are concerns that a considerable sodium load can be ingested via certain effervescent, dispersible, and soluble formulations of medicines. AREAS COVERED: Reducing dietary sodium intake in the general population has resulted in a significant reduction in cardiovascular disease outcomes. However, no previous studies have highlighted the potential risk of cardiovascular disease by taking sodium-containing medicines such as soluble forms of aspirin, paracetamol, ibuprofen, and other common drugs. We recently conducted a nested case-control study in the UK general population using the UK Clinical Practice Research Datalink to study the long-term use of sodium-containing medicines and cardiovascular outcomes. The results showed that compared with standard formulations, patients who took sodium-containing medicines were 16% more likely to develop cardiovascular events (OR = 1.16, 95% CI 1.12 - 1.21). The risks for stroke and hypertension were even higher, (1.22 [1.16 - 1.29] and 7.18 [6.74 - 7.65]), respectively. EXPERT OPINION: Sodium-containing formulations should be prescribed with caution only if the perceived benefits outweigh the risks.