Fatal and Nonfatal Outcomes, Incidence of Hypertension, and Blood Pressure Changes in Relation to Urinary Sodium Excretion

Katarzyna Stolarz-Skrzypek, Tatiana Kuznetsova, Lutgarde Thijs, Valerie Tikhonoff, Jitka Seidlerova, Tom Richart, Yu Jin, Agnieszka Olszanecka, Sofia Malyutina, Edoardo Casiglia, Jan Filipovsky, Kalina Kawecka-Jaszcz, Yuri Nikitin, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Context Extrapolations from observational studies and short-term intervention trials suggest that population-wide moderation of salt intake might reduce cardiovascular events. Objective To assess whether 24-hour urinary sodium excretion predicts blood pressure (BP) and health outcomes. Design, Setting, and Participants Prospective population study, involving 3681 participants without cardiovascular disease (CVD) who are members of families that were randomly enrolled in the Flemish Study on Genes, Environment, and Health Outcomes (1985-2004) or in the European Project on Genes in Hypertension (1999-2001). Of 3681 participants without CVD, 2096 were normotensive at baseline and 1499 had BP and sodium excretion measured at baseline and last follow-up (2005-2008). Main Outcome Measures Incidence of mortality and morbidity and association between changes in BP and sodium excretion. Multivariable-adjusted hazard ratios (HRs) express the risk in tertiles of sodium excretion relative to average risk in the whole study population. Results Among 3681 participants followed up for a median 7.9 years, CVD deaths decreased across increasing tertiles of 24-hour sodium excretion, from 50 deaths in the low (mean, 107 mmol), 24 in the medium (mean, 168 mmol), and 10 in the high excretion group (mean, 260 mmol; P
Original languageEnglish
Pages (from-to)1777-1785
JournalJAMA-Journal of the American Medical Association
Issue number17
Publication statusPublished - 4 May 2011

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