• Yume Nohara-Shitama, Hisashi Adachi, Mika Enomoto, Ako Fukami, Eita Kumagai, Sachiko Nakamura, Shoko Kono, Nagisa Morikawa, Erika Nakao, Akiko Sakaue, Tomoko Tsuru, and Yoshihiro Fukumoto.
• Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
• J Am Heart Assoc. 2018 Jan 4; 7 (1).

BackgroundFew studies have examined the relationship between accurate monitoring of sodium or potassium consumption and mortality. We aimed to investigate the association between 24-hour urinary sodium or potassium excretion and ≈30-year mortality in a Japanese population using 24-hour urine collection.Methods And ResultsWe enrolled a total of 1291 participants, aged 21 to 85 years, who underwent health checkups, including a blood test and 24-hour urine collection. They were followed up for 27.5±9.9 years by December 31, 2015, and the final follow-up rate was 95.8%. Cox proportional hazards regression analysis was used to assess the association between 24-hour urinary sodium or potassium excretion and all-cause mortality. At baseline, the mean 24-hour urinary sodium and potassium excretions were 5.80±2.28 g/d and 1.85±0.82 g/d, respectively. There were 631 deaths during the follow-up. The cumulative survival rate was significantly decreased in the lowest quartile compared with the other higher groups. In the Cox proportional hazard model after adjustment for age and sex, 24-hour urinary potassium excretion, but not sodium excretion, was inversely associated with all-cause mortality. We divided the 24-hour urinary potassium excretion levels into quartiles. After adjustment for confounding factors, the hazard ratio of all-cause mortality in the highest quartile of 24-hour urinary potassium excretion versus the lowest was 0.62 (95% confidence interval, 0.48-0.79; P<0.001).ConclusionsThe 24-hour urinary potassium excretion, but not sodium excretion, was significantly associated with all-cause mortality in the general population.© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

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