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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #354357
Title: Longitudinal change of perceived salt intake and stroke risk in a Chinese population

Author
item LI, YUN - North China University Of Science And Technology
item HUANG, ZHE - Kailuan Hospital
item JIN, CHENG - Kailuan Hospital
item XING, AIJUN - Kailuan Hospital
item LIU, YESONG - Kailuan Hospital
item HUANGFU, CHUNMEI - Kailuan Hospital
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item TUCKER, KATHERINE - University Of Massachusetts
item WU, SHOULING - Kailuan Hospital
item GAO, XIANG - Pennsylvania State University

Submitted to: Stroke
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/9/2018
Publication Date: 5/8/2018
Citation: Li, Y., Huang, Z., Jin, C., Xing, A., Liu, Y., Huangfu, C., Lichtenstein, A.H., Tucker, K.L., Wu, S., Gao, X. 2018. Longitudinal change of perceived salt intake and stroke risk in a Chinese population. Stroke. 49(6):1332-1339. https://doi.org/10.1161/STROKEAHA.117.020277.
DOI: https://doi.org/10.1161/STROKEAHA.117.020277

Interpretive Summary: Data to support a relationship between salt intake and stroke have been inconsistent. Little information is available on the potential effect of changes in salt intake over time on stroke risk. Examined was the potential association between longitudinal change of salt intake and stroke risk in a Chinese population during the period between 2006 and 2010. Identified were 5 distinct trajectories of perceived salt intake: moderate-stable, moderate-decreasing, moderate-increasing, low-increasing and high-decreasing. Compared to individuals with the moderate-stable salt intake trajectory, individuals with moderate-decreasing salt intake trajectory had significantly lower stroke risk. The association was significant for cerebral infarction stroke. A similar non-significant association was observed for intracerebral hemorrhage. Further adjustment for perceived salt intake during 2006 or 2010 generated similar results. When baseline salt intake was used as an exposure, a significant dose-response relation was observed between higher salt intake and higher stroke risk. The results of this study suggest that salt intake trajectories were directly associated with the risk of stroke. Reduction of salt intake from moderate to low level might be an effective lifestyle strategy to lower the stroke risk.

Technical Abstract: Background and Purpose-Data for a relationship between salt intake and stroke have been inconsistent. This inconstancy could be because of the majority of studies evaluated salt intake at a single time point, which may be insufficient to accurately characterize salt intake throughout the observation period. Methods-Included were 77,605 participants from the Kailuan study. We assessed perceived salt intake via questionnaire in 2006, 2008, and 2010. Salt intake trajectories from 2006 to 2010 were identified using latent mixture models. Incident stroke cases were identified from 2010 to 2015 and confirmed by review of medical records. Cox proportional hazards model was used to examine the association between salt intake trajectories and stroke risk after adjusting for possible confounders, including age, sex, lifestyle, social economic status, body mass index, use of medicines, blood pressure, and lipoprotein profiles. Results-Identified were 5 distinct salt intake trajectories: moderate-stable (n=59,241), moderate-decreasing (n=9268), moderate-increasing (n=2975), low-increasing (n=2879), and high-decreasing (n=3242). During the 5-year follow-up period, there were 1564 incident strokes cases. Compared with individuals with the moderate-stable salt intake trajectory, individuals with moderate-decreasing salt intake trajectory had significantly lower cerebral infarction stroke risk (adjusted hazard ratio, 0.76; 95% confidence interval, 0.63-0.92) but not intracerebral hemorrhage risk (adjusted hazard ratio, 0.84; 95% confidence interval, 0.55-1.29). Further adjustment for 2006 or 2010 perceived salt intakes generated similar results. When baseline perceived salt intake only was used as the exposure, a significant dose-response relationship between higher perceived salt intake and higher stroke risk was observed (P trend=0.006). Conclusions-Change in salt intake was associated with the stroke risk. These data support the dietary recommendation to the reduction of salt intake.