ArticleAmerican journal of hypertension2021
Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study.
Article in American journal of hypertension, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 13 citations in OpenAlex.
- Sodium reduction and salt substitutes: impact on blood pressure and recurrent stroke.Current opinion in cardiology · 2026Review
- Attributable risk and time trend in hemorrhagic and ischemic stroke mortality due to high sodium intake in Zhenjiang City from 2010 to 2021: an Age-Period-Cohort (APC) analysis.Frontiers in stroke · 2026Article
- Simple methods for estimating the maximum 24-hour urinary potassium excretion in kidney failure without replacement therapy patients.Renal failure · 2025Article
- Blood pressure variability in acute stroke: Risk factors and association with functional outcomes at 1 month.European journal of neurology · 2024Article
- Association of Metallic and Nonmetallic Elements with Fibrin Clot Properties and Ischemic Stroke.Life (Basel, Switzerland) · 2024Article
- Estimation of dietary intake of sodium, potassium, phosphorus and protein in healthy Indian population and patients with chronic kidney disease.Frontiers in nutrition · 2024Article
- Electrolyte Imbalance and Neurologic Injury.CNS & neurological disorders drug targets · 2024Review
- The association between sodium intake and coronary and carotid atherosclerosis in the general Swedish population.European heart journal open · 2023Article
- Prediction Tool to Estimate Potassium Diet in Chronic Kidney Disease Patients Developed Using a Machine Learning Tool: The UniverSel Study.Nutrients · 2022Article
- Application of a six sigma model to evaluate the analytical performance of urinary biochemical analytes and design a risk-based statistical quality control strategy for these assays: A multicenter study.Journal of clinical laboratory analysis · 2021Article
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37 authors at 20 institutions in 25 countries.
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Abstract
backgroundAlthough low sodium intake (<2 g/day) and high potassium intake (>3.5 g/day) are proposed as public health interventions to reduce stroke risk, there is uncertainty about the benefit and feasibility of this combined recommendation on prevention of stroke.
methodsWe obtained random urine samples from 9,275 cases of acute first stroke and 9,726 matched controls from 27 countries and estimated the 24-hour sodium and potassium excretion, a surrogate for intake, using the Tanaka formula. Using multivariable conditional logistic regression, we determined the associations of estimated 24-hour urinary sodium and potassium excretion with stroke and its subtypes.
resultsCompared with an estimated urinary sodium excretion of 2.8-3.5 g/day (reference), higher (>4.26 g/day) (odds ratio [OR] 1.81; 95% confidence interval [CI], 1.65-2.00) and lower (<2.8 g/day) sodium excretion (OR 1.39; 95% CI, 1.26-1.53) were significantly associated with increased risk of stroke. The stroke risk associated with the highest quartile of sodium intake (sodium excretion >4.26 g/day) was significantly greater (P < 0.001) for intracerebral hemorrhage (ICH) (OR 2.38; 95% CI, 1.93-2.92) than for ischemic stroke (OR 1.67; 95% CI, 1.50-1.87). Urinary potassium was inversely and linearly associated with risk of stroke, and stronger for ischemic stroke than ICH (P = 0.026). In an analysis of combined sodium and potassium excretion, the combination of high potassium intake (>1.58 g/day) and moderate sodium intake (2.8-3.5 g/day) was associated with the lowest risk of stroke.
conclusionsThe association of sodium intake and stroke is J-shaped, with high sodium intake a stronger risk factor for ICH than ischemic stroke. Our data suggest that moderate sodium intake-rather than low sodium intake-combined with high potassium intake may be associated with the lowest risk of stroke and expected to be a more feasible combined dietary target.
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