ArticleJournal of the American Medical Directors Association2018
Association Between Sodium Excretion and Cardiovascular Disease and Mortality in the Elderly: A Cohort Study.
Article in Journal of the American Medical Directors Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Sodium and Potassium Intake and Cardiovascular Disease in Older People: A Systematic Review.Nutrients · 2020Pooled it
- Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis.Nutrients · 2020Pooled it
- Dietary Sodium Intake and Health Indicators: A Systematic Review of Published Literature between January 2015 and December 2019.Advances in nutrition (Bethesda, Md.) · 2020Pooled it
- Science of Salt: A regularly updated systematic review of salt and health outcomes studies (April to October 2018).Journal of clinical hypertension (Greenwich, Conn.) · 2019Pooled it
- Sodium Intake and Incident Atrial Fibrillation in Individuals With Vascular Disease.JAMA network open · 2024Trial
- Guidelines for daily sodium intake: a counterpoint to the current recommendation for low sodium intake.Sleep advances : a journal of the Sleep Research Society · 2026Review
- Associations and mediators of estimated sodium intake with cardiovascular mortality: data based on a national population cohort.BMC medicine · 2025Article
- Rethinking salt reduction in older adults with hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Association between salt intake and blood pressure among community-dwelling older adults based on their physical frailty status.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Dietary sodium intake and all-cause mortality in rheumatoid arthritis: an NHANES analysis (2003-2018).Frontiers in nutrition · 2025Article
- Association between sodium and potassium intake levels and body compositions of Chinese college students.Asia Pacific journal of clinical nutrition · 2023Article
- Sex-specific associations between potassium intake, blood pressure, and cardiovascular outcomes: the EPIC-Norfolk study.European heart journal · 2022Article
- Independent and interactive associations of dietary nitrate and salt intake with blood pressure and cognitive function: a cross-sectional analysis in the InCHIANTI study.International journal of food sciences and nutrition · 2022Article
- Sodium-containing acetaminophen and cardiovascular outcomes in individuals with and without hypertension.European heart journal · 2022Article
- Epithelial Sodium Channel Alpha Subunit (αENaC) Is Associated with Inverse Salt Sensitivity of Blood Pressure.Biomedicines · 2022Article
- Urinary sodium excretion and the risk of CVD: a community-based cohort study in Taiwan.The British journal of nutrition · 2022Article
- Review
- Sodium Intake, Blood Pressure and Cardiovascular Disease.Korean circulation journal · 2020Review
- Dietary Potassium Intake Remains Low and Sodium Intake Remains High, and Most Sodium is Derived from Home Food Preparation for Chinese Adults, 1991-2015 Trends.The Journal of nutrition · 2020Article
- Dietary reference values for sodium.EFSA journal. European Food Safety Authority · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveHigh dietary sodium intake is a risk factor for cardiovascular events and death. Recently, a J-shaped correlation between sodium intake and adverse outcomes has been shown. The evidence on the association between sodium intake and cardiovascular outcomes in the elderly is scant. The objective of this study was to evaluate the correlation between sodium intake and cardiovascular events and mortality in an elderly population, taking into account frailty status.
designCohort study of community dwelling older people enrolled in the InCHIANTI (Invecchiare in Chianti - Aging in the Chianti) study from 1998 to 2000 and followed-up for 9 years.
settingTwo communities in Tuscany, Italy.
participantsA total of 920 participants 65 years of age and older, with 24-hour urinary sodium excretion data. MEASUREMENTS: Nine-year mortality and incident cardiovascular events were analyzed using Cox and nonlinear log-binomial models, stratified by frailty status. Sensitivity analysis in participants without hypertension and cardiovascular diseases was performed.
resultsMean age of the population was 74.5 years (standard deviation 6.99); 55.4% were women. There was a bi-modal association between sodium excretion and mortality, with risk increasing only below sodium excretion of 6.25 g/d [hazard ratio (HR) 1.29, 95% confidence interval (CI) 1.20-1.38], confirmed in the adjusted model (HR 1.12, 95% CI 1.04-1.22). These results were confirmed in participants without cardiovascular diseases. After stratification for frailty phenotype, the association was stronger in frail participants (adjusted HR 1.23, 95% CI 1.02-1.50 vs HR 1.11, 95% CI 1.01-1.22 in robust participants). There was no association between 24-hour sodium excretion and 9-year incidence of cardiovascular diseases (adjusted risk ratio 0.96, 95% CI 0.90-1.02).
conclusionsReduced sodium excretion is associated with increased mortality in a sample of community-dwelling older people, especially among the frail participants. High levels of sodium excretion are not associated with adverse outcomes in this population; therefore, sodium restriction might not be beneficial in older people.
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