Potassium intake and risk of stroke in women with hypertension and nonhypertension in the Women's Health Initiative.
Potassium intake and risk of stroke in women with hypertension and nonhypertension in the Women's Health Initiative.
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DOI：
10.1161/strokeaha.114.006046
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发表时间：
2014-10
期刊：
影响因子：
8.3
通讯作者：
Wassertheil-Smoller S
中科院分区：
文献类型：
--
作者：
Seth A;Mossavar-Rahmani Y;Kamensky V;Silver B;Lakshminarayan K;Prentice R;Van Horn L;Wassertheil-Smoller S
膳食钾与较低的中风风险相关，但关于膳食钾对不同中风亚型或老年高血压和非高血压女性的影响的数据很少。研究人群包括90,137名年龄在50-79岁之间的绝经后女性，基线时没有中风史，前瞻性随访平均11年。结果变量包括总卒中、缺血性卒中、出血性卒中和全因死亡率。比较了饮食中钾摄入量的四分位数的发病率，在调整了潜在的混杂变量后，从COX比例风险模型中获得了危险比，分别在高血压和非高血压女性中进行了比较。平均膳食钾素摄入量为2611 mg/d。钾摄入量最高的四分位数与较低的缺血性和出血性中风发生率以及总死亡率相关。多因素分析显示，全因死亡率为0.90(95%CI：0.85-0.95)，全卒中为0.88(95%CI：0.79-0.98)，缺血性卒中为0.84(95%CI：0.74-0.96)。对缺血性中风的影响在非高血压女性中更为明显，她们的风险降低了27%，HR为0.73(95%CI：0.60-0.88)，交互作用p值为0.10。与出血性中风无关。在老年女性中，高钾摄入量与所有中风和缺血性中风的风险以及各种原因的死亡率有关，特别是那些没有高血压的女性。
Dietary potassium has been associated with lower risk of stroke but there is little data on dietary potassium effects on different stroke subtypes or in older hypertensive and non-hypertensive women. The study population consisted of 90,137 postmenopausal women aged 50–79 at enrollment, free of stroke history at baseline, followed prospectively for an average of 11 years. Outcome variables were total, ischemic, and hemorrhagic stroke, and all-cause mortality. Incidence was compared across quartiles of dietary potassium intake and hazard ratios were obtained from Cox proportional hazards models after adjusting for potential confounding variables, and in hypertensive and non-hypertensive women separately. Mean dietary potassium intake was 2611 mg/day. Highest quartile of potassium intake was associated with lower incidence of ischemic and hemorrhagic stroke, and total mortality. Multivariate analyses comparing highest to lowest quartile of potassium intake, indicated a hazard ratio (HR) for all-cause mortality of 0.90 (95% CI: 0.85 – 0.95), for all stroke of HR=0.88 (95% CI: 0.79 – 0.98), and for ischemic stroke of 0.84 (95% CI: 0.74 – 0.96). The effect on ischemic stroke was more apparent in non-hypertensive women among whom there was a 27% lower risk with HR of 0.73 (95% CI: 0.60 – 0.88), interaction p-value <.10. There was no association with hemorrhagic stroke. High potassium intake is associated with a lower risk of all stroke and ischemic stroke as well as all-cause mortality in older women, particularly those who are not hypertensive.