Highlights
- •Lower urinary K excretion was associated with higher risk of cerebro-cardiovascular and renal (CCR) events.
- •Lower urinary K excretion was associated with higher risk of all-cause mortality.
- •There was no association between urinary NaCl excretion and CCR events.
- •There was no association between urinary NaCl excretion and all-cause mortality.
Abstract
Background
Hypertension is one of the risk factors for cerebro-cardiovascular and renal (CCR)
diseases. High blood pressure is affected by the amount of salt (NaCl) and potassium
(K) intake. There are many studies reporting the relationship between urinary sodium
or potassium excretion and CCR events or all-cause mortality in general populations.
Thus, it is necessary to investigate the relationship between urinary NaCl or K excretion
and CCR events or all-cause mortality in hypertensive patients under control with
anti-hypertensive drugs.
Methods
A prospective, multi-center cohort study was performed in 3210 hypertensives under
treatment with anti-hypertensive drugs for 5 years. The primary outcome was the CCR
events, and the secondary outcome was all-cause mortality. A time-dependent Cox proportional
hazards regression analysis was performed to assess the association between outcomes
and urinary NaCl and K excretion, blood pressure, or heart rate.
Results
During the follow-up period, 61 CCR events and 110 all-cause deaths occurred. There
was no association between urinary NaCl excretion and CCR events or all-cause mortality.
Lower urinary K excretion and higher Na/K ratio were associated with higher risk of
CCR events or all-cause mortality. The CCR events were not associated with systolic,
diastolic blood pressure, or heart rate.
Conclusion
Lower urinary K excretion was associated with higher risk of CCR events or all-cause
mortality in hypertensive patients under treatment with anti-hypertensive drugs.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: August 18, 2022
Accepted:
July 5,
2022
Received in revised form:
July 3,
2022
Received:
May 7,
2022
Footnotes
☆There is no conflict of interest and the authors have nothing to disclose. Source of support: Gifu University Graduate School of Medicine to SM.
☆☆Public trials registry number: UMIN000006866 (https://www.umin.ac.jp). IRB information: The Ethics Committee of Gifu University Graduate School of Medicine approved this study (Approval number: 23-181 & 2019-099).
Identification
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© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
