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Urinary sodium and potassium excretion and cerebrovascular health: a multimodal imaging study

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Abstract

Purpose

Dietary sodium and potassium intake are associated with stroke, but the potential mechanisms are unclear. We aimed to study the association between sodium and potassium intake and subclinical cerebrovascular health in hypertensive older males using multimodal magnetic resonance imaging.

Methods

A total of 189 hypertensive male subjects without previous cardiovascular or cerebrovascular disease were included. Daily urinary sodium and potassium excretion were estimated from a fasting spot urine sample using a formula approach. A dedicated cerebrovascular health imaging protocol including vessel wall imaging, angiography, arterial spin labeling imaging and T2-weighted fluid-attenuated inversion recovery imaging was performed to study intracranial atherosclerosis, vascular rarefaction (defined as fewer discernible vessels on angiography), brain perfusion and small vessel disease, respectively.

Results

The mean age was 64.9 (± 7.2) years. The average daily urinary and potassium excretion was 4.7 (± 1.4) g/L and 2.1 (± 0.5) g/L, respectively. Increased urinary sodium excretion was associated with decreased cerebral blood flow and elevated urinary potassium excretion was associated with reduced prevalence of intracranial plaque. The associations remained significant after adjusting for covariates, even including blood pressure control. Quadratic regression analysis indicated a marginally significant U-shaped association between urinary sodium intake and white matter hyperintensity, which lost significance in fully adjusted models. No significant association of urinary sodium and potassium excretion with other cerebrovascular health measures was noted.

Conclusion

We concluded that in hypertensive older males without overt cardiovascular disease, increased sodium intake and reduced potassium intake are associated with impaired subclinical cerebrovascular health.

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Data availability

All the relevant data have been presented in this paper. Further request should be addressed to Dr. Junwei Yang.

Code availability

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Funding

The study is supported by a grant from Jiangsu Science and Technology Department (BE2017762) to Dr. Junwei Yang.

Author information

Author notes

  1. Wenjin Liu, Xiaoqin Huang and Xuebing Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, University of Washington, Seattle, WA, USA

    Wenjin Liu, Zhensen Chen, Dakota Ortega, Jie Sun & Chun Yuan

  2. Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# Zhongshan North Road, Nanjing, Jiangsu, China

    Xiaoqin Huang, Lulu Wang & Junwei Yang

  3. Department of Radiology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan, Nanjing, Jiangsu, China

    Xuebing Liu & Haige Li

  4. Electrical and Computer Engineering, University of Washington, Seattle, WA, USA

    Li Chen

  5. Department of Surgery, Division of Vascular Surgery, University of Washington, Seattle, WA, USA

    Thomas S. Hatsukami

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  1. Wenjin Liu
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Correspondence to Haige Li or Junwei Yang.

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The study was approved by the Institutional Ethics Committee of The Second Affiliated Hospital of Nanjing Medical University and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Liu, W., Huang, X., Liu, X. et al. Urinary sodium and potassium excretion and cerebrovascular health: a multimodal imaging study. Eur J Nutr 60, 4555–4563 (2021). https://doi.org/10.1007/s00394-021-02612-1

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  • DOI: https://doi.org/10.1007/s00394-021-02612-1

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