Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults.
Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults.
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DOI：
10.1097/00008483-200007000-00013
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发表时间：
1999-12
期刊：
影响因子：
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通讯作者：
Jiang He;L. Ogden;S. Vupputuri;L. Bazzano;C. Loria;P. Whelton
中科院分区：
文献类型：
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作者：
Jiang He;L. Ogden;S. Vupputuri;L. Bazzano;C. Loria;P. Whelton
饮食中的钠与血压呈正相关，生态学和动物研究都表明，高饮食中的钠摄入会增加中风死亡率。目的研究超重和非超重人群中与膳食钠摄入相关的心血管疾病风险。设计前瞻性队列研究。第一次全国健康和营养调查流行病学随访研究，在1982-1984年，1986年，1987年和1992年进行。对象1971 ~ 1975年调查时年龄在25 ~ 74岁的14407人中，超重者2688人，非超重者6797人。主要观察指标：采用24小时膳食回忆法，在基线时估计膳食钠和能量摄入量。心血管疾病的发病率和死亡率数据来自医疗记录和死亡证明。结果：对于超重和非超重的人，在平均19年的随访中，记录的病例总数如下：680例中风事件（210例死亡），1727例冠心病事件（614例死亡），895例心血管疾病死亡，2486例全因死亡。在平均能量摄入量为7452千焦的超重人群中，钠摄入量增加100 mmol与增加32%相关（相对风险[RR]，1.32; 95%置信区间[CI]，1.07-1.64; P = .01），卒中发生率增加89%（RR，1.89; 95% CI，1.31-2.74; P<.001），卒中死亡率增加44%（RR，1.44; 95% CI，1.14-1.81; P = .002）冠心病死亡率增加61%（RR，1.61; 95%CI，1.32-1.96; P<.001），所有原因的死亡率增加39%（RR，1.39; 95%CI，1.23-1.58; P<.001）。在非超重人群中，膳食钠摄入量与心血管疾病风险无显著相关性。结论：我们的分析表明，高钠摄入量与超重人群心血管疾病风险和全因死亡率增加密切相关。
CONTEXT Dietary sodium is positively associated with blood pressure, and ecological and animal studies both have suggested that high dietary sodium intake increases stroke mortality. OBJECTIVE To examine the risk of cardiovascular disease associated with dietary sodium intake in overweight and nonoverweight persons. DESIGN Prospective cohort study. SETTING The first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, conducted in 1982-1984, 1986, 1987, and 1992. PARTICIPANTS Of those aged 25 to 74 years when the survey was conducted in 1971 -1975 (14407 participants), a total of 2688 overweight and 6797 nonoverweight persons were included in the analysis. MAIN OUTCOME MEASURES Dietary sodium and energy intake were estimated at baseline using a single 24-hour dietary recall method. Incidence and mortality data for cardiovascular disease were obtained from medical records and death certificates. RESULTS For overweight and nonoverweight persons, over an average of 19 years of follow-up, the total number of documented cases were as follows: 680 stroke events (210 fatal), 1727 coronary heart disease events (614 fatal), 895 cardiovascular disease deaths, and 2486 deaths from all causes. Among overweight persons with an average energy intake of 7452 kJ, a 100 mmol higher sodium intake was associated with a 32% increase (relative risk [RR], 1.32; 95% confidence interval [CI], 1.07-1.64; P = .01) in stroke incidence, 89% increase (RR, 1.89; 95% CI, 1.31-2.74; P<.001) in stroke mortality, 44% increase (RR, 1.44; 95% CI, 1.14-1.81; P = .002) in coronary heart disease mortality, 61% increase (RR, 1.61; 95% CI, 1.32-1.96; P<.001) in cardiovascular disease mortality, and 39% increase (RR, 1.39; 95% CI, 1.23-1.58; P<.001) in mortality from all causes. Dietary sodium intake was not significantly associated with cardiovascular disease risk in nonoverweight persons. CONCLUSIONS Our analysis indicates that high sodium intake is strongly and independently associated with an increased risk of cardiovascular disease and all-cause mortality in overweight persons.