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High sodium intake harms cardiac structure, function
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Estimated sodium intake of more than 3.7 g per day was associated with adverse cardiac remodeling, worse systolic strain and worse diastolic e’ velocity, according to research published in the Journal of the American College of Cardiology.
Researchers performed speckle-tracking analysis of 2,996 patients (mean age, 49 years; 57% women; 50% black) from the HyperGEN database with available echocardiograms and urinary sodium data.
They evaluated the associations between estimated sodium intake and longitudinal strain, circumferential strain and e’ velocity. They also performed a mediation analysis to determine the indirect effects of systolic BP and serum aldosterone on the relationships studied.
Median estimated sodium intake was 3.73 g per day (interquartile range, 3.24-4.25).
The researchers found estimated sodium intake greater than 3.7 g per day was associated with larger left atrial and left ventricular dimensions (P < .05).
After adjustment for speckle-tracking analysis, image quality, study site, age, sex, smoking status, alcohol consumption, daily blocks walked, use of diuretics, estimated glomerular filtration rate, LV mass, ejection fraction and wall motion score index, estimated sodium intake greater than 3.7 g per day was associated with longitudinal strain, circumferential strain and e’ velocity (P < .05 for all), but intake up to 3.7 g was not (P > .05 for all).
The researchers determined that systolic BP explained 14% of the indirect effects between estimated sodium intake and longitudinal strain and 20% of the indirect effects between estimated sodium intake and e’ velocity, and serum aldosterone explained 19% of the indirect effects between estimated sodium intake and longitudinal strain.
“These data provide support for the adverse [CV] effects (including direct myocardial effects) of high sodium intake,” the researchers wrote.
Thomas H. Marwick, MBBS, PhD, MPH, from the Baker Heart and Diabetes Institute, Melbourne, Australia, wrote in a related editorial that, “An effect on myocardial function, independent of BP, could be a powerful argument to instigate reduced salt intake in individuals at risk of substantial dysfunction, including those with hypertension and type 2 diabetes.” – by Erik Swain
Disclosures: One author reports receiving an investigator-initiated grant from Merck. Marwick reports no relevant financial disclosures.
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