title: Small increases in plasma sodium are associated with higher risk of mortality in a healthy population.
abstract: Elevated blood pressure (BP) is the most common cause of cardiovascular disease. Salt intake has a strong influence on BP, and plasma sodium (pNa) is increased with progressive increases in salt intake. However, the associations with pNa and BP had been reported inconsistently. We evaluated the association between pNa and BP, and estimated the risks of all-cause-mortality according to pNa levels. On the basis of data collected from health checkups during 1995-2009, 97,009 adult subjects were included. Positive correlations between pNa and systolic BP, diastolic BP, and pulse pressure (PP) were noted in participants with pNa ≥138 mM/L (P<0.001). In participants aged ≥50 yr, SBP, DBP, and PP were positively associated with pNa. In participants with metabolic syndrome components, the differences in SBP and DBP according to pNa were greater (P<0.001). A cumulative incidence of mortality was increased with increasing pNa in women aged ≥50 yr during the median 4.2-yr-follow-up (P<0.001). In women, unadjusted risks for mortality were increased according to sodium levels. After adjustment, pNa ≥145 mM/L was related to mortality. The positive correlation between pNa and BP is stronger in older subjects, women, and subjects with metabolic syndrome components. The incidence and adjusted risks of mortality increase with increasing pNa in women aged ≥50 yr.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
authors.forename: Se Won
authors.initials: SW
authors.lastname: Oh
authors.forename: Seon Ha
authors.initials: SH
authors.lastname: Baek
authors.forename: Jung Nam
authors.initials: JN
authors.lastname: An
authors.forename: Ho Suk
authors.initials: HS
authors.lastname: Goo
authors.forename: Sejoong
authors.initials: S
authors.lastname: Kim
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Na
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Chae
authors.forename: Suhnggwon
authors.initials: S
authors.lastname: Kim
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Chin
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012964:Sodium / Q000097:blood*
chemical_list: D012964:Sodium
keywords: Age; Blood Pressure; Mortality; Plasma Sodium; Sex Characteristics