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Estimated salt intake and risk of atrial fibrillation in a prospective community-based cohort

Wuopio, J. ; Orho-Melander, M. LU ; Ärnlöv, J. and Nowak, C. (2021) In Journal of Internal Medicine 289(5). p.700-708
Abstract

Introduction: Hypertension predisposes to atrial fibrillation (AF) – a major risk factor for ischaemic stroke. Since a high dietary salt consumption is associated with hypertension, we investigated the association between urinary sodium excretion as a marker for dietary sodium intake and risk of new-onset AF in community-dwelling adults. Method: The UK Biobank includes 40- to 69-year-old British residents recruited 2006–2010. Participants were divided into sex-specific quintiles according to 24-hour sodium excretion estimated based on spot samples with the Kawasaki equation. We excluded participants with AF at baseline. Cox regression adjusted for cardiovascular risk factors was used to assess associations with risk of AF, using the... (More)

Introduction: Hypertension predisposes to atrial fibrillation (AF) – a major risk factor for ischaemic stroke. Since a high dietary salt consumption is associated with hypertension, we investigated the association between urinary sodium excretion as a marker for dietary sodium intake and risk of new-onset AF in community-dwelling adults. Method: The UK Biobank includes 40- to 69-year-old British residents recruited 2006–2010. Participants were divided into sex-specific quintiles according to 24-hour sodium excretion estimated based on spot samples with the Kawasaki equation. We excluded participants with AF at baseline. Cox regression adjusted for cardiovascular risk factors was used to assess associations with risk of AF, using the third quintile as reference. Results: A total of 257 545 women and 215 535 men were included. During up to 10 years' follow-up, 2221 women and 3751 men were diagnosed with AF. There was a tendency for an increased risk of AF in the lowest and highest quintiles of estimated daily salt intake in both women and men. In the fully adjusted model, significant associations were seen amongst men in the lowest and highest quintiles of sodium excretion (hazard ratio, HRQv1, 1.20; 95% CI, 1.08–1.32, P < 0.001, and HRQv5 1.15, 95% CI, 1.03–1.27, P = 0.011). Conclusion: We found evidence for a U-shaped association between estimated daily salt intake and AF risk amongst men. A suggestive J-shaped association in women was not statistically confirmed, but analyses were likely underpowered. Our results suggest that above a certain physiological minimum level progressively higher salt intake is associated with increasing risk of AF.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atrial fibrillation, blood pressure, dietary salt, hypertension, Kawasaki formulae, sodium excretion
in
Journal of Internal Medicine
volume
289
issue
5
pages
9 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85096690908
  • pmid:33210391
ISSN
0954-6820
DOI
10.1111/joim.13194
language
English
LU publication?
yes
id
f92d6221-96f2-4b96-b50d-5769cdc1f8f3
date added to LUP
2020-12-08 11:13:41
date last changed
2024-06-13 01:16:57
@article{f92d6221-96f2-4b96-b50d-5769cdc1f8f3,
  abstract     = {{<p>Introduction: Hypertension predisposes to atrial fibrillation (AF) – a major risk factor for ischaemic stroke. Since a high dietary salt consumption is associated with hypertension, we investigated the association between urinary sodium excretion as a marker for dietary sodium intake and risk of new-onset AF in community-dwelling adults. Method: The UK Biobank includes 40- to 69-year-old British residents recruited 2006–2010. Participants were divided into sex-specific quintiles according to 24-hour sodium excretion estimated based on spot samples with the Kawasaki equation. We excluded participants with AF at baseline. Cox regression adjusted for cardiovascular risk factors was used to assess associations with risk of AF, using the third quintile as reference. Results: A total of 257 545 women and 215 535 men were included. During up to 10 years' follow-up, 2221 women and 3751 men were diagnosed with AF. There was a tendency for an increased risk of AF in the lowest and highest quintiles of estimated daily salt intake in both women and men. In the fully adjusted model, significant associations were seen amongst men in the lowest and highest quintiles of sodium excretion (hazard ratio, HR<sub>Qv1</sub>, 1.20; 95% CI, 1.08–1.32, P &lt; 0.001, and HR<sub>Qv5</sub> 1.15, 95% CI, 1.03–1.27, P = 0.011). Conclusion: We found evidence for a U-shaped association between estimated daily salt intake and AF risk amongst men. A suggestive J-shaped association in women was not statistically confirmed, but analyses were likely underpowered. Our results suggest that above a certain physiological minimum level progressively higher salt intake is associated with increasing risk of AF.</p>}},
  author       = {{Wuopio, J. and Orho-Melander, M. and Ärnlöv, J. and Nowak, C.}},
  issn         = {{0954-6820}},
  keywords     = {{atrial fibrillation; blood pressure; dietary salt; hypertension; Kawasaki formulae; sodium excretion}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  pages        = {{700--708}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Internal Medicine}},
  title        = {{Estimated salt intake and risk of atrial fibrillation in a prospective community-based cohort}},
  url          = {{http://dx.doi.org/10.1111/joim.13194}},
  doi          = {{10.1111/joim.13194}},
  volume       = {{289}},
  year         = {{2021}},
}