Evidence map›Paper›PMID 34767706›Full record

ArticleThe New England journal of medicine2022

24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk.

Yuan Ma, Feng J He, Qi Sun, Changzheng Yuan, Lyanne M Kieneker, Gary C Curhan, Graham A MacGregor, Stephan J L Bakker, Norm R C Campbell, Molin Wang and 7 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 165 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
165citing papers in PubMed, 7 pooled it
24.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

165 citing papers in PubMed, 7 syntheses or guidelines pooled it, 270 citations in OpenAlex.

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  19. K-SALT Equation for Urinary Sodium Estimation in CKD.Kidney international reports · 2026
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105 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 1 institution in 1 country.

Yuan MaFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).ORCID 0000-0002-0207-3620
Feng J HeFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Qi SunFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Changzheng YuanFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Lyanne M KienekerFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Gary C CurhanFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Graham A MacGregorFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Stephan J L BakkerFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Norm R C CampbellFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Molin WangFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Eric B RimmFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
JoAnn E MansonFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Walter C WillettFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Albert HofmanFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Ron T GansevoortFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Nancy R CookFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
Frank B HuFrom the Departments of Epidemiology (Y.M., Q.S., G.C.C., M.W., E.B.R., J.E.M., W.C.W., A.H., N.R.C., F.B.H.) and Nutrition (Q.S., C.Y., E.B.R., W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, and the Channing Division of Network Medicine, the Department of Medicine (Q.S., G.C.C., E.B.R., J.E.M., W.C.W., F.B.H.), Renal Division, the Department of Medicine (G.C.C.), and the Division of Preventive Medicine (J.E.M., N.R.C.), Brigham and Women's Hospital and Harvard Medical School - all in Boston; the Wolfson Institute of Population Health, St. Bartholomew's Hospital and the London School of Medicine and Dentistry, Queen Mary University of London, London (F.J.H., G.A.M.); the Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (L.M.K., S.J.L.B., R.T.G.); and the Departments of Medicine, Community Health Sciences, and Physiology and Pharmacology, O'Brien Institute of Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada (N.R.C.C.).
United States Nuclear Regulatory Commission · US

Funding

University of Hawaii Cancer Center CCSGP30CA071789 · NCI · UNIVERSITY OF HAWAII AT MANOA · PI GERTRAUD MASKARINEC · 1996 to 2026
$56.2M
Validity of Diet and Activity Measures in WomenP01CA055075 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI SPIEGELMAN, DONNA L · 1991 to 2009
$41.8M
Life Course Cancer Epidemiology Cohort in WomenU01CA176726 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI ELIASSEN, A. HEATHER, WILLETT, WALTER C. · 2018 to 2025
$22.4M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Integrating lifecourse approaches, biologic and digital phenotypes in support of heart and lung disease epidemiologic researchU01HL145386 · NHLBI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI CHAVARRO, JORGE EDUARDO, MANSON, JOANN ELISABETH · 2019 to 2025
$17.8M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
Life Course Cancer Epidemiology Cohort in WomenUM1CA176726 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2013 to 2017
$15.7M
RISK FACTORS FOR CVD IN WOMENR01HL034594 · NHLBI · TULANE UNIVERSITY OF LOUISIANA · PI JoAnn Elisabeth Manson, Lu Qi · 1985 to 2026
$13.8M
Dietary Etiology of Heart DiseaseR01HL035464 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ERIC B RIMM, Qi Sun · 1986 to 2026
$13.6M
Cancer Epidemiology Cohort in Male Health ProfessionalsUM1CA167552 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2012 to 2016
$11.5M
DIETARY PATTERNS AND RISK OF CARDIOVASCULAR DISEASER01HL060712 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HU, FRANK B, QI, QIBIN · 1998 to 2021
$8.0M
Pollutant-related diabetes in the Nurses' Health Study IIR01ES021372 · NIEHS · HARVARD SCHOOL OF PUBLIC HEALTH · PI GRANDJEAN, PHILIPPE ADAM, SUN, QI · 2013 to 2017
$2.9M
American Heart Association 20POST35120057, 14GRNT18440013NCI NIH HHS P01 CA055075NCI NIH HHS P30 CA071789NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA176726NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA176726NCI NIH HHS UM1 CA186107NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL057915NHLBI NIH HHS R01 HL060712NHLBI NIH HHS U01 HL145386NIA NIH HHS K99 AG071742NIDDK NIH HHS R01 DK059583NIDDK NIH HHS R01 DK082486NIEHS NIH HHS R01 ES021372NIH HHS CA186107, CA176726, CA167552, CA055075, CA071789,NIH HHS K99AG071742
6 · The paper itself

Abstract

backgroundThe relation between sodium intake and cardiovascular disease remains controversial, owing in part to inaccurate assessment of sodium intake. Assessing 24-hour urinary excretion over a period of multiple days is considered to be an accurate method.

methodsWe included individual-participant data from six prospective cohorts of generally healthy adults; sodium and potassium excretion was assessed with the use of at least two 24-hour urine samples per participant. The primary outcome was a cardiovascular event (coronary revascularization or fatal or nonfatal myocardial infarction or stroke). We analyzed each cohort using consistent methods and combined the results using a random-effects meta-analysis.

resultsAmong 10,709 participants, who had a mean (±SD) age of 51.5±12.6 years and of whom 54.2% were women, 571 cardiovascular events were ascertained during a median study follow-up of 8.8 years (incidence rate, 5.9 per 1000 person-years). The median 24-hour urinary sodium excretion was 3270 mg (10th to 90th percentile, 2099 to 4899). Higher sodium excretion, lower potassium excretion, and a higher sodium-to-potassium ratio were all associated with a higher cardiovascular risk in analyses that were controlled for confounding factors (P≤0.005 for all comparisons). In analyses that compared quartile 4 of the urinary biomarker (highest) with quartile 1 (lowest), the hazard ratios were 1.60 (95% confidence interval [CI], 1.19 to 2.14) for sodium excretion, 0.69 (95% CI, 0.51 to 0.91) for potassium excretion, and 1.62 (95% CI, 1.25 to 2.10) for the sodium-to-potassium ratio. Each daily increment of 1000 mg in sodium excretion was associated with an 18% increase in cardiovascular risk (hazard ratio, 1.18; 95% CI, 1.08 to 1.29), and each daily increment of 1000 mg in potassium excretion was associated with an 18% decrease in risk (hazard ratio, 0.82; 95% CI, 0.72 to 0.94).

conclusionsHigher sodium and lower potassium intakes, as measured in multiple 24-hour urine samples, were associated in a dose-response manner with a higher cardiovascular risk. These findings may support reducing sodium intake and increasing potassium intake from current levels. (Funded by the American Heart Association and the National Institutes of Health.).

Indexed as

AdultAgedCardiovascular DiseasesFemaleHeart Disease Risk FactorsHumansIncidenceMaleMiddle AgedPotassiumProspective StudiesSodiumSodium, DietaryPotassiumSodiumSodium, Dietary

Identifiers

PMID34767706
PMCPMC9153854
OpenAlexW3212379938

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.