Sodium Intake and Risk of Death From Stroke in Japanese Men and Women

Background and Purpose— Despite the evidence for a positive association of dietary salt and blood pressure, the few prospective studies that have assessed the association between dietary salt and stroke have reported inconsistent results. The purpose of this study was to examine the relation between sodium intake and death from stroke in a population-based cohort of Japanese men and women. Methods— In 1992, usual diet including sodium intake was determined in 13 355 men and 15 724 women in Takayama City, Gifu, with the use of a validated food frequency questionnaire. Results— There were 269 stroke deaths (137 men and 132 women) between baseline and 1999. In men, the highest compared with the lowest tertile of sodium intake was significantly positively associated with death from total stroke after controlling for covariates (hazard ratio [HR]), 2.33; 95% CI, 1.23 to 4.45). Significantly positive associations were also observed between sodium intake and death from ischemic stroke (HR, 3.22; 95% CI, 1.22 to 8.53) as well as death from intracerebral hemorrhage (HR, 3.85; 95% CI, 1.16 to 12.7). A positive association between sodium intake and death from stroke in women was suggested, although the associations for total stroke and ischemic stroke were of borderline significance (HR, 1.70; 95% CI, 0.96 to 3.02 and HR, 2.10; 95% CI, 0.96 to 4.62, respectively). Conclusions— These prospective data support the hypothesis that dietary salt increases the risk of death from stroke.

[1]  A. Dobrian,et al.  Effect of salt on hypertension and oxidative stress in a rat model of diet-induced obesity. , 2003, American journal of physiology. Renal physiology.

[2]  J. Tuomilehto,et al.  Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study , 2001, The Lancet.

[3]  H. Taira.  Standard tables of food composition in Japan, fifth revised edition , 2001 .

[4]  A. Chobanian,et al.  National Heart, Lung, and Blood Institute Workshop on Sodium and Blood Pressure : a critical review of current scientific evidence. , 2000, Hypertension.

[5]  G. Lammie.  Pathology of small vessel stroke. , 2000, British medical bulletin.

[6]  P. Whelton,et al.  Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults. , 1999, JAMA.

[7]  C. Nagata,et al.  Validity and reproducibility of a quantitative food frequency questionnaire for a cohort study in Japan. , 1999, Japanese journal of clinical oncology.

[8]  P. J. Jones,et al.  Dietary sodium intake and mortality. , 2009, Nutrition reviews.

[9]  W. Willett.  Implications of Total Energy Intake for Epidemiologic Analyses , 1998 .

[10]  M. Safar,et al.  Effects of a chronic high-salt diet on large artery structure: role of endogenous bradykinin. , 1998, The American journal of physiology.

[11]  M. Alderman,et al.  Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I) , 1998, The Lancet.

[12]  M. Hennerici,et al.  Acute Stroke Subtypes – Is There a Need for Reclassification? , 1998, Cerebrovascular Diseases.

[13]  C. Nagata,et al.  Decreased serum total cholesterol concentration is associated with high intake of soy products in Japanese men and women. , 1998, The Journal of nutrition.

[14]  M. Katan.  Biochemical indicators of dietary intake. , 1998 .

[15]  J. Laragh,et al.  Low urinary sodium is associated with greater risk of myocardial infarction among treated hypertensive men. , 1995, Hypertension.

[16]  S. Sasaki,et al.  Dietary sodium, potassium, saturated fat, alcohol, and stroke mortality. , 1995, Stroke.

[17]  I. Perry,et al.  Salt intake and stroke: a possible direct effect. , 1992, Journal of human hypertension.

[18]  S. Sasaki,et al.  The relationship between urinary cations obtained from the INTERSALT study and cerebrovascular mortality. , 1992, Journal of human hypertension.

[19]  H. Iso,et al.  [A population-based study of the proportion by type of stroke determined by computed tomography scan]. , 1991, [Nihon koshu eisei zasshi] Japanese journal of public health.

[20]  L. Tobian,et al.  High Sodium Chloride Diets Injure Arteries and Raise Mortality Without Changing Blood Pressure , 1990, Hypertension.

[21]  V. Katch,et al.  The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents. , 1989, The New England journal of medicine.

[22]  K. Yano,et al.  Dietary and other risk factors for stroke in Hawaiian Japanese men. , 1985, Stroke.