Abstract: TH-PO1138
The Association between Serum Sodium and Potassium Concentration and the Risk of Cardiovascular Disease: A Large Community-Based Cohort Study
Session Information
- Fluid, Electrolyte, Acid-Base Disorders
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Fluid, Electrolytes, and Acid-Base
- 704 Fluid, Electrolyte, Acid-Base Disorders
Authors
- Cole, Nicholas I., Epsom and St Helier NHS Trust, London, United Kingdom
- Swift, Pauline A., Epsom and St Helier NHS Trust, London, United Kingdom
- He, Feng J., Queen Mary University of London, London, United Kingdom
- Hinton, William, University of Surrey, Guildford, United Kingdom
- Ferreira, Filipa I m, University of Surrey, Guildford, United Kingdom
- De lusignan, Simon, University of Surrey, Guildford, United Kingdom
- Suckling, Rebecca, Epsom and St Helier NHS Trust, London, United Kingdom
Background
Observational and randomised studies have shown that reduced dietary sodium (Na) and higher potassium (K) are associated with lower blood pressure and cardiovascular (CV) disease. Changes in dietary intake may alter the serum concentration of these electrolytes, but few studies have investigated if there is a relationship between serum Na, K and CV risk.
Methods
This was a retrospective cohort study using data from the Royal College of General Practitioners Research and Surveillance Centre, a database of routinely-collected primary care data in the UK. Data were extracted using Read V2 and EMIS codes. Only individuals with both a serum Na and K value were included, with the most recent data prior to April 2010 used to define baseline levels. Exclusion criteria were: age less than 40 years; diabetes mellitus; prior CV event; end-stage renal disease; liver cirrhosis. The primary outcome was incident CV disease (acute coronary syndrome; coronary revascularisation; stroke; new diagnosis of heart failure) over 5 years.
Results
235,676 individuals met the criteria for inclusion in the study. The median age was 59 years (IQR 49-68), 57% were female, and 5% were known to be of non-white ethnicity. The median serum Na was 140 mmol/L (IQR 139-142), and the median serum K was 4.4 mmol/L (IQR 4.1-4.6). 21% were prescribed at least one diuretic medication, and 23% were prescribed a renin angiotensin system (RAS) inhibitor. There were 9,464 (4.0%) incident CV events during the follow-up period. After multivariate adjustment for confounding factors, there were significant associations between the primary outcome and serum Na (≤ 140 and ≥ 144 mmol/L) and serum K (≥ 4.5 mmol/L) – see Figure. No relationship with blood pressure was demonstrated.
Conclusion
There is a significant association between serum Na, serum K and primary CV events. This relationship is unexplained but could be associated with activation of the RAS.