Evaluation of sodium intake for the prediction of cardiovascular events in Japanese high-risk patients: the ESPRIT Study

Sadanaga, Tsuneaki; Hirota, Shinichi; Enomoto, Koji; Kohsaka, Shun; Tsujita, Kenichi; Ito, Miwa; Mitamura, Hideo; Fukuda, Keiichi

doi:10.1038/s41440-018-0149-7

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…In the present study, a post hoc analysis of the ESPRIT study ( 4 ) was performed and it was found that a high Na/Cr ratio in spot urine was associated with hospitalization for HF in high-risk Japanese patients. The strength of this sub-analysis is that a simple marker of the Na/Cr ratio in spot urine, when measured repeatedly, was associated with hospitalizations for HF either in univariate analysis or following adjustment for several factors, such as age, sex, body weight, BNP, eGFR, diabetes mellitus, or the use of diuretics.…”

Section: Discussionmentioning

confidence: 82%

“…Thus, sacubitril/valsaltan and SGLT2 inhibitors, which were widely used in patients with HF, were not available. Other limitations for the original ESPRIT study were described previously ( 4 ), in particular, the marked heterogeneity of the included patients was a major concern.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, a post hoc analysis of the previously published ESPRIT study ( 4 ) was performed. The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Institutional Ethics Committee of Ueki Hospital, and informed written consent was obtained from all the patients.…”

Section: Methodsmentioning

confidence: 99%

“…The ESPRIT study ( 4 ) (Evaluation of sodium Intake for the prediction of cardiovascular events in Japanese high-risk patients) revealed that a high sodium excretion ≥4.0 g/day, assessed by repeated measurements of spot urine, was associated with composite cardiovascular events in Japanese high-risk patients. During the median follow-up period of 5.2 years in 520 enrolled patients, 105 (20%) experienced composite cardiovascular events, which were predominantly driven by 60 (12%) hospitalizations due to HF.…”

Section: Introductionmentioning

confidence: 99%

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Sodium to creatinine ratio in spot urine is associated with heart failure hospitalization in Japanese high‑risk patients

Sadanaga¹,

Hirota

2022

Exp Ther Med

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Our previous study [Evaluation of sodium intake for the prediction of cardiovascular events in Japanese high-risk patients (ESPRIT study)] reported that increased sodium excretion ≥4.0 g/day was associated with composite cardiovascular events in hospitalization for heart failure (HF), acute coronary syndrome, cerebrovascular events and documented cardiovascular-related mortality in Japanese high-risk patients with either stable and compensated HF, coronary artery disease, cerebrovascular disease, chronic kidney disease or atrial fibrillation. However, the method of estimating sodium excretion levels using spot urine is complex, requiring age, body weight, height and multiplier factors for calculation. The aim of the present study was to elucidate whether the sodium to creatinine ratio in spot urine, a key component in estimating daily sodium excretion, was associated with hospitalization for HF. The present study performed a post-hoc analysis of the ESPRIT study (n=520; 60 hospitalizations for HF). Receiver operating curve analysis yielded an optimal sodium to creatinine ratio cut-off value of 24.8 for detecting hospitalization for HF. Kaplan-Meier curve analysis revealed that a high sodium to creatinine ratio in spot urine was associated with an increased hospitalization for HF (P<0.001). Cox regression analysis revealed that a high sodium to creatinine ratio was associated with hospitalization for HF with a hazard ratio (HR) of 2.49 [95% confidence interval (95% CI), 1.47-4.16]. Following adjustment for age, sex and body weight, the HR was as high as 2.74 (95% CI, 1.51-4.71). This association remained following further adjustment for brain natriuretic peptide, estimated glomerular filtration rate, diabetes mellitus or the use of diuretics. Overall, the present study demonstrated that the sodium to creatinine ratio in spot urine is associated with hospitalization for HF in Japanese high-risk patients.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sodium to creatinine ratio in spot urine is associated with heart failure hospitalization in Japanese high‑risk patients

Sadanaga¹,

Hirota

2022

Exp Ther Med

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“…Salt sensitivity is defined as the association between sodium intake and the increased risk of cardiovascular diseases in certain populations or individuals. Sodium intake may have differing effects on the individual’s cardiovascular outcomes like stroke, myocardial infarction, cardiovascular death, and congestive heart failure ( O’Donnell et al, 2011 ; Sadanaga et al, 2019 ; Welsh et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Nitric Oxide Alleviated High Salt–Induced Cardiomyocyte Apoptosis and Autophagy Independent of Blood Pressure in Rats

Mao

et al. 2021

Front. Cell Dev. Biol.

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The present study aimed to explore whether high-salt diet (HSD) could cause cardiac damage independent of blood pressure, and whether nitric oxide (NO) could alleviate high-salt–induced cardiomyocyte apoptosis and autophagy in rats. The rats received 8% HSD in vivo. H9C2 cells or primary neonatal rat cardiomyocytes (NRCM) were treated with sodium chloride (NaCl) in vitro. The levels of cleaved-caspase 3/caspase 3, cleaved-caspase 8/caspase 8, Bax/Bcl2, LC3 II/LC3 I, Beclin-1 and autophagy related 7 (ATG7) were increased in the heart of HSD rats with hypertension (HTN), and in hypertension-prone (HP) and hypertension-resistant (HR) rats. Middle and high doses (50 and 100 mM) of NaCl increased the level of cleaved-caspase 3/caspase 3, cleaved-caspase 8/caspase 8, Bax/Bcl2, LC3 II/LC3 I, Beclin-1, and ATG7 in H9C2 cells and NRCM. The endothelial NO synthase (eNOS) level was increased, but p-eNOS level was reduced in the heart of HSD rats and H9C2 cells treated with 100 mM NaCl. The level of NO was reduced in the serum and heart of HSD rats. NO donor sodium nitroprusside (SNP) reversed the increases of cleaved-caspase 3/caspase 3, cleaved-caspase 8/caspase 8, Bax/Bcl2 induced by NaCl (100 mM) in H9C2 cells and NRCM. SNP treatment attenuated the increases of cleaved-caspase 3/caspase 3, Bax/Bcl2, LC3 II/LC3 I, Beclin-1, and ATG7 in the heart, but had no effect on the blood pressure of HSD rats with HR. These results demonstrated that HSD enhanced cardiac damage independently of blood pressure. Exogenous NO supplementarity could alleviate the high salt–induced apoptosis and autophagy in cardiomyocytes.

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Factors associated with heart failure hospitalization in patients with high sodium excretion: subanalysis of the ESPRIT, evaluation of sodium intake for the prediction of cardiovascular events in Japanese high-risk patients, cohort study

Sadanaga¹,

Hirota²,

Mitamura

2020

Heart Vessels

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Evaluation of sodium intake for the prediction of cardiovascular events in Japanese high-risk patients: the ESPRIT Study

Cited by 8 publications

References 23 publications

Sodium to creatinine ratio in spot urine is associated with heart failure hospitalization in Japanese high‑risk patients

Sodium to creatinine ratio in spot urine is associated with heart failure hospitalization in Japanese high‑risk patients

Nitric Oxide Alleviated High Salt–Induced Cardiomyocyte Apoptosis and Autophagy Independent of Blood Pressure in Rats

Factors associated with heart failure hospitalization in patients with high sodium excretion: subanalysis of the ESPRIT, evaluation of sodium intake for the prediction of cardiovascular events in Japanese high-risk patients, cohort study

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