Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort

ObjectivesThe objective of this study was to examine the relationship between dietary sodium intake and cardiovascular disease (CVD) mortality in hypertensive American adults.MethodsA prospective cohort study was conducted to examine the association between dietary sodium intake, as estimated by a s...

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Main Authors: Zhiqiang Chen, Jingan Rao, Weiguo Fan, Zuxiang Wu, Yumeng Shi, Yingxing Wu, Huan Hu, Xiaoshu Cheng, Ping Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1471647/full
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author Zhiqiang Chen
Zhiqiang Chen
Jingan Rao
Weiguo Fan
Zuxiang Wu
Yumeng Shi
Yingxing Wu
Huan Hu
Xiaoshu Cheng
Ping Li
author_facet Zhiqiang Chen
Zhiqiang Chen
Jingan Rao
Weiguo Fan
Zuxiang Wu
Yumeng Shi
Yingxing Wu
Huan Hu
Xiaoshu Cheng
Ping Li
author_sort Zhiqiang Chen
collection DOAJ
description ObjectivesThe objective of this study was to examine the relationship between dietary sodium intake and cardiovascular disease (CVD) mortality in hypertensive American adults.MethodsA prospective cohort study was conducted to examine the association between dietary sodium intake, as estimated by a single 24-h dietary recall from the National Health and Nutrition Examination Survey (2003–2012), and mortality data obtained from the National Death Index.ResultsThis study included 12,236 adults with hypertension, with 837 CVD-related deaths identified over a median follow-up period of 10.3 years. A nonlinear association between dietary sodium intake and CVD mortality was observed. The inflection point of the curve occurred at a sodium intake level of 2.07 g/day. Below this threshold, higher sodium intake was associated with a reduced risk of CVD mortality, though the association was not statistically significant after full adjustment (aHR: 0.78, 95% CI: 0.58–1.05). In contrast, sodium intake above 2.07 g/day was significantly associated with an increased risk of CVD mortality (aHR: 1.12, 95% CI: 1.02–1.23). The log-likelihood ratio test yielded a P-value of 0.04. This J-shaped association was observed exclusively in females, not males. Among females, the adjusted hazard ratios (95% CI) were 0.65 (0.42, 0.99) below and 1.29 (1.11, 1.53) above the inflection point (P for log-likelihood ratio test = 0.009).ConclusionsIn American adults with hypertension, dietary sodium intake exceeding 2.07 g/day was significantly associated with an increased risk of CVD mortality, while intake below this threshold was not significantly linked to mortality risk. Additionally, a sex-specific effect of dietary sodium intake on CVD mortality was observed, showing a J-shaped relationship exclusively in females, with no such association found in males.
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spelling doaj-art-be2f7d70b0e54e27a3629745b2dc404c2025-08-20T02:27:46ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-11-011110.3389/fcvm.2024.14716471471647Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohortZhiqiang Chen0Zhiqiang Chen1Jingan Rao2Weiguo Fan3Zuxiang Wu4Yumeng Shi5Yingxing Wu6Huan Hu7Xiaoshu Cheng8Ping Li9Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaObjectivesThe objective of this study was to examine the relationship between dietary sodium intake and cardiovascular disease (CVD) mortality in hypertensive American adults.MethodsA prospective cohort study was conducted to examine the association between dietary sodium intake, as estimated by a single 24-h dietary recall from the National Health and Nutrition Examination Survey (2003–2012), and mortality data obtained from the National Death Index.ResultsThis study included 12,236 adults with hypertension, with 837 CVD-related deaths identified over a median follow-up period of 10.3 years. A nonlinear association between dietary sodium intake and CVD mortality was observed. The inflection point of the curve occurred at a sodium intake level of 2.07 g/day. Below this threshold, higher sodium intake was associated with a reduced risk of CVD mortality, though the association was not statistically significant after full adjustment (aHR: 0.78, 95% CI: 0.58–1.05). In contrast, sodium intake above 2.07 g/day was significantly associated with an increased risk of CVD mortality (aHR: 1.12, 95% CI: 1.02–1.23). The log-likelihood ratio test yielded a P-value of 0.04. This J-shaped association was observed exclusively in females, not males. Among females, the adjusted hazard ratios (95% CI) were 0.65 (0.42, 0.99) below and 1.29 (1.11, 1.53) above the inflection point (P for log-likelihood ratio test = 0.009).ConclusionsIn American adults with hypertension, dietary sodium intake exceeding 2.07 g/day was significantly associated with an increased risk of CVD mortality, while intake below this threshold was not significantly linked to mortality risk. Additionally, a sex-specific effect of dietary sodium intake on CVD mortality was observed, showing a J-shaped relationship exclusively in females, with no such association found in males.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1471647/fullCVDmortalityhypertensiondietary sodium intakefemaleNational Health and Nutrition Examination Surveys
spellingShingle Zhiqiang Chen
Zhiqiang Chen
Jingan Rao
Weiguo Fan
Zuxiang Wu
Yumeng Shi
Yingxing Wu
Huan Hu
Xiaoshu Cheng
Ping Li
Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort
Frontiers in Cardiovascular Medicine
CVD
mortality
hypertension
dietary sodium intake
female
National Health and Nutrition Examination Surveys
title Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort
title_full Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort
title_fullStr Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort
title_full_unstemmed Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort
title_short Sex modifies association between dietary sodium intake and cardiovascular disease mortality among US adult with hypertension: a national population-based cohort
title_sort sex modifies association between dietary sodium intake and cardiovascular disease mortality among us adult with hypertension a national population based cohort
topic CVD
mortality
hypertension
dietary sodium intake
female
National Health and Nutrition Examination Surveys
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1471647/full
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