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Abstract: FR-PO559

The Association of Hyponatremia With Cognitive Function and All-Cause Mortality: A Post Hoc Analysis of the Systolic Blood Pressure Intervention Trial

Session Information

Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders

  • 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical

Authors

  • Sarwal, Amara, University of Utah Health, Salt Lake City, Utah, United States
  • Boucher, Robert E., University of Utah Health, Salt Lake City, Utah, United States
  • Abraham, Nikita, University of Utah Health, Salt Lake City, Utah, United States
  • Singh, Ravinder, University of Utah Health, Salt Lake City, Utah, United States
  • Ye, Xiangyang, University of Utah Health, Salt Lake City, Utah, United States
  • Moghaddam, Farahnaz Akrami, University of Utah Health, Salt Lake City, Utah, United States
  • Hartsell, Sydney Elizabeth, University of Utah Health, Salt Lake City, Utah, United States
  • Wei, Guo, University of Utah Health, Salt Lake City, Utah, United States
  • Beddhu, Srinivasan, University of Utah Health, Salt Lake City, Utah, United States
Background

Severe hyponatremia (hypoNa) needing treatment with hypertonic saline was associated with probable dementia (PD) in a retrospective study. It is unknown whether mild hyponatremia is a risk factor for mild cognitive impairment (MCI)/ PD.

Methods

The Systolic Blood Pressure Intervention Trial (SPRINT) MIND study (N= 8561) evaluated the effects of intensive systolic BP control (goa l< 120mmHg) vs. standard SBP control (goal < 140 mmHg) on risk of adjudicated MCI/PD. In this post-hoc secondary analysis, we included 8541 SPRINT-MIND participants with baseline serum Na > 130 meq/L and non-missing baseline and 6-months (6m) serum Na. We defined incident hypoNa as a serum Na < 130 mmol/L at m6 and related incident hypoNa with time to MCI alone, PD alone, a composite of MCI/PD and all-cause mortality (ACM) in separate Cox regression models adjusted for the SBP intervention, age, gender, race, CVD, CHF, smoking, BMI and eGFR.

Results

The mean baseline serum Na was 140 ± 2 meq/L. 129 (1.5%) participants developed incident hyponatremia at 6m with a mean serum sodium of 127±3 meq/L. Compared to those without incident hyponatremia, those with incident hyponatremia were in general, older, had lower BMI and more likely to be women, African-American, treated with thiazide diuretics and assigned to intensive SBP arm. The mean follow-up duration was 4.8 ± 1.4 yrs. There were 1254 MCI, 324 PD, 1485 MCI/PD and 324 ACM events. As shown in table incident hypoNa was not associated with MCI or MCI/PD composite but with higher risk of PD and ACM.

Conclusion

In this post hoc analysis of SPRINT, while hypoNa was not associated with subsequent MCI or MCI/PD, it was associated with PD and ACM.

 MCIPDMCI/PDACM
Unadjusted0.84 (0.50, 1.43)2.46 (1.31, 4.61)1.17 (0.78, 1.77)1.64 (0.77, 3.46)
+ SBP intervention, age, gender, race0.83 (0.49, 1.40)2.00 (1.06, 3.77)1.10 (0.73, 1.66)1.59 (0.75, 3.37)
+ CVD, CHF, smoking, BMI, eGFR0.83 (0.49, 1.42)2.12 (1.12, 4.01)1.12 (0.74, 1.69)1.82 (0.85, 3.87)