Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study
Objectives To evaluate the impact of dietary sodium and potassium (Na–K) ratio on mortality from total and subtypes of stroke, cardiovascular disease (CVD) and all causes, using 24-year follow-up data of a representative sample of the Japanese population.Setting Prospective cohort study.Participants...
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BMJ Publishing Group
2016-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/6/7/e011632.full |
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| author | Hirofumi Ohnishi Yoshitaka Murakami Katsuyuki Miura Koji Tamakoshi Hirotsugu Ueshima Akira Okayama Tomonori Okamura Takayoshi Ohkubo Toshiyuki Ojima Yoshihiro Miyamoto Maryam Zaid Aya Kadota Akira Fujiyoshi Yosikazu Nakamura Naoyuki Takashima Atsushi Hozawa Shigeyuki Saitoh Yutaka Kiyohara Fumiyoshi Kasagi Nagako Okuda Takehito Hayakawa Hiroshi Akasaka Yusuke Arai Katsushi Yoshita Kiyomi Sakata Nobuo Nishi Toru Izumi Yasuhiro Matsumura Hideaki Nakagawa Yoshikuni Kita Naomi Miyamatsu Yasuyuki Nakamura Kazunori Kodama |
| author_facet | Hirofumi Ohnishi Yoshitaka Murakami Katsuyuki Miura Koji Tamakoshi Hirotsugu Ueshima Akira Okayama Tomonori Okamura Takayoshi Ohkubo Toshiyuki Ojima Yoshihiro Miyamoto Maryam Zaid Aya Kadota Akira Fujiyoshi Yosikazu Nakamura Naoyuki Takashima Atsushi Hozawa Shigeyuki Saitoh Yutaka Kiyohara Fumiyoshi Kasagi Nagako Okuda Takehito Hayakawa Hiroshi Akasaka Yusuke Arai Katsushi Yoshita Kiyomi Sakata Nobuo Nishi Toru Izumi Yasuhiro Matsumura Hideaki Nakagawa Yoshikuni Kita Naomi Miyamatsu Yasuyuki Nakamura Kazunori Kodama |
| collection | DOAJ |
| description | Objectives To evaluate the impact of dietary sodium and potassium (Na–K) ratio on mortality from total and subtypes of stroke, cardiovascular disease (CVD) and all causes, using 24-year follow-up data of a representative sample of the Japanese population.Setting Prospective cohort study.Participants In the 1980 National Cardiovascular Survey, participants were followed for 24 years (NIPPON DATA80, National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged). Men and women aged 30–79 years without hypertensive treatment, history of stroke or acute myocardial infarction (n=8283) were divided into quintiles according to dietary Na–K ratio assessed by a 3-day weighing dietary record at baseline. Age-adjusted and multivariable-adjusted HRs were calculated using the Mantel-Haenszel method and Cox proportional hazards model.Primary outcome measures Mortality from total and subtypes of stroke, CVD and all causes.Results A total of 1938 deaths from all causes were observed over 176 926 person-years. Na–K ratio was significantly and non-linearly related to mortality from all stroke (p=0.002), CVD (p=0.005) and total mortality (p=0.001). For stroke subtypes, mortality from haemorrhagic stroke was positively related to Na–K ratio (p=0.024). Similar relationships were observed for men and women. The observed relationships remained significant after adjustment for other risk factors. Quadratic non-linear multivariable-adjusted HRs (95% CI) in the highest quintile versus the lowest quintile of Na–K ratio were 1.42 (1.07 to 1.90) for ischaemic stroke, 1.57 (1.05 to 2.34) for haemorrhagic stroke, 1.43 (1.17 to 1.76) for all stroke, 1.39 (1.20 to 1.61) for CVD and 1.16 (1.06 to 1.27) for all-cause mortality.Conclusions Dietary Na–K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population. |
| format | Article |
| id | doaj-art-22ae2b553f36424c9f46c5d4c9f95b3d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2016-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-22ae2b553f36424c9f46c5d4c9f95b3d2025-02-11T12:40:08ZengBMJ Publishing GroupBMJ Open2044-60552016-07-016710.1136/bmjopen-2016-011632Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study 0Hirofumi Ohnishi1Yoshitaka Murakami2Katsuyuki Miura3Koji TamakoshiHirotsugu Ueshima4Akira Okayama5Tomonori Okamura6Takayoshi Ohkubo7Toshiyuki Ojima8Yoshihiro Miyamoto9Maryam Zaid10Aya Kadota11Akira Fujiyoshi12Yosikazu Nakamura13Naoyuki Takashima14Atsushi Hozawa15Shigeyuki Saitoh16Yutaka Kiyohara17Fumiyoshi Kasagi18Nagako Okuda19Takehito Hayakawa20Hiroshi Akasaka21Yusuke Arai22Katsushi Yoshita23Kiyomi SakataNobuo Nishi24Toru IzumiYasuhiro MatsumuraHideaki NakagawaYoshikuni KitaNaomi MiyamatsuYasuyuki Nakamura25Kazunori Kodama26Kenya National Bureau of Statistics, Nairobi, Nairobi, Kenya2 Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, JapanDepartment of Medical Statistics, Toho University, Ota-ku, Tokyo, JapanNCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan7 Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan1Research Institute of Strategy for Prevention, Tokyo, JapanDepartment of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku-ku, Tokyo, JapanHygiene and Public Health, Teikyo University School of Medicine, Itabashi-ku, JapanDepartment of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, JapanNational Cerebral and Cardiovascular Center, Suita, Osaka, JapanShiga University of Medical Science, Otsu, Shiga, JapanDepartment of Public Health, Shiga University of Medical Science, Otsu, JapanShiga University of Medical Science, Otsu, Shiga, Japan3 Department of Public Health, Jichi Medical University, Shimotsuke, Japan20 Department of Health Science, Shiga University of Medical Science, Otsu, Japan1 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan8Division of Medical and Behavioral Subjects, Sapporo Medical University School of Health Science, Sapporo, Japan1Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japanvisiting researcher2Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan6Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan7Second Department of Internal Medicine, Sapporo Medical University, Sapporo, Japan9Department of Nutrition and Health, Chiba Prefectural University of Health Sciences, Chiba, Japan11Department of Food and Nutrition, Osaka City University, Osaka, Japanassistant department chiefDepartment of Public Health, Shiga University of Medical Science, Otsu, Japanchief scientistObjectives To evaluate the impact of dietary sodium and potassium (Na–K) ratio on mortality from total and subtypes of stroke, cardiovascular disease (CVD) and all causes, using 24-year follow-up data of a representative sample of the Japanese population.Setting Prospective cohort study.Participants In the 1980 National Cardiovascular Survey, participants were followed for 24 years (NIPPON DATA80, National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged). Men and women aged 30–79 years without hypertensive treatment, history of stroke or acute myocardial infarction (n=8283) were divided into quintiles according to dietary Na–K ratio assessed by a 3-day weighing dietary record at baseline. Age-adjusted and multivariable-adjusted HRs were calculated using the Mantel-Haenszel method and Cox proportional hazards model.Primary outcome measures Mortality from total and subtypes of stroke, CVD and all causes.Results A total of 1938 deaths from all causes were observed over 176 926 person-years. Na–K ratio was significantly and non-linearly related to mortality from all stroke (p=0.002), CVD (p=0.005) and total mortality (p=0.001). For stroke subtypes, mortality from haemorrhagic stroke was positively related to Na–K ratio (p=0.024). Similar relationships were observed for men and women. The observed relationships remained significant after adjustment for other risk factors. Quadratic non-linear multivariable-adjusted HRs (95% CI) in the highest quintile versus the lowest quintile of Na–K ratio were 1.42 (1.07 to 1.90) for ischaemic stroke, 1.57 (1.05 to 2.34) for haemorrhagic stroke, 1.43 (1.17 to 1.76) for all stroke, 1.39 (1.20 to 1.61) for CVD and 1.16 (1.06 to 1.27) for all-cause mortality.Conclusions Dietary Na–K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population.https://bmjopen.bmj.com/content/6/7/e011632.full |
| spellingShingle | Hirofumi Ohnishi Yoshitaka Murakami Katsuyuki Miura Koji Tamakoshi Hirotsugu Ueshima Akira Okayama Tomonori Okamura Takayoshi Ohkubo Toshiyuki Ojima Yoshihiro Miyamoto Maryam Zaid Aya Kadota Akira Fujiyoshi Yosikazu Nakamura Naoyuki Takashima Atsushi Hozawa Shigeyuki Saitoh Yutaka Kiyohara Fumiyoshi Kasagi Nagako Okuda Takehito Hayakawa Hiroshi Akasaka Yusuke Arai Katsushi Yoshita Kiyomi Sakata Nobuo Nishi Toru Izumi Yasuhiro Matsumura Hideaki Nakagawa Yoshikuni Kita Naomi Miyamatsu Yasuyuki Nakamura Kazunori Kodama Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study BMJ Open |
| title | Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study |
| title_full | Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study |
| title_fullStr | Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study |
| title_full_unstemmed | Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study |
| title_short | Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study |
| title_sort | dietary sodium to potassium ratio as a risk factor for stroke cardiovascular disease and all cause mortality in japan the nippon data80 cohort study |
| url | https://bmjopen.bmj.com/content/6/7/e011632.full |
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