title: Cardiovascular risk associated with sodium-containing medicines.
abstract: BACKGROUND
  It is widely recognized that excess sodium intake increases the risk of hypertension, and this subsequently increases the risk of cardiovascular disease. Although efforts are being made to reduce sodium intake in the population in general, there are concerns that a considerable sodium load can be ingested via certain effervescent, dispersible, and soluble formulations of medicines.
  
  
  METHODS
  Reducing dietary sodium intake in the general population has resulted in a significant reduction in cardiovascular disease outcomes. However, no previous studies have highlighted the potential risk of cardiovascular disease by taking sodium-containing medicines such as soluble forms of aspirin, paracetamol, ibuprofen, and other common drugs. We recently conducted a nested case-control study in the UK general population using the UK Clinical Practice Research Datalink to study the long-term use of sodium-containing medicines and cardiovascular outcomes. The results showed that compared with standard formulations, patients who took sodium-containing medicines were 16% more likely to develop cardiovascular events (OR = 1.16, 95% CI 1.12 - 1.21). The risks for stroke and hypertension were even higher, (1.22 [1.16 - 1.29] and 7.18 [6.74 - 7.65]), respectively.
  
  
  CONCLUSIONS
  Sodium-containing formulations should be prescribed with caution only if the perceived benefits outweigh the risks.
authors.affiliation: University College London, School of Pharmacy, Department of Practice and Policy , Entrance A, BMA House, Tavistock Square, London WC1H 9JP , UK +44 020 7874 1275 ; +44 020 7387 5693 ; l.wei@ucl.ac.uk.
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.forename: Isla S
authors.initials: IS
authors.lastname: Mackenzie
authors.forename: Thomas M
authors.initials: TM
authors.lastname: MacDonald
authors.forename: Jacob
authors.initials: J
authors.lastname: George
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D002626:Chemistry, Pharmaceutical; D006801:Humans; D016017:Odds Ratio; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000737:chemistry; D064167:Recommended Dietary Allowances; D018570:Risk Assessment; D012307:Risk Factors; D012964:Sodium / Q000008:administration & dosage* / Q000009:adverse effects* / Q000737:chemistry; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000009:adverse effects; D013997:Time Factors
chemical_list: D004364:Pharmaceutical Preparations; D012982:Sodium, Dietary; D012964:Sodium
keywords: cardiovascular risk; observational study; public health; sodium-containing medicines