Excessive Amounts of Salt Consumption and Atheroma Formation Among Patients Awaiting Coronary-Artery-Bypass-Grafting at A Tertiary Care Hospital in Sri Lanka

Abstract

Background:Ischemic Heart Disease(IHD) characterized by atheroma formation, is a leading contributor for the rising disease burden of chronic non-communicable diseases in Sri Lanka. Even though excessive salt-consumption has been attributed with hypertension, documented literature is scarce on exploring its direct association with atheroma formation with primary data. Coronary-Artery- Bypass-Grafting(CABG) is done as a tertiary preventive measure for IHDs. The aim was to estimate the sodium-intake and to describe the association of salt consumption and atheroma formation among preoperative patients undergoing CABG at Sri Jayewardenepura General Hospital, Sri Lanka.MethodsA descriptive cross-sectional study was done on a calculated sample size of 213 participants who were awaiting CABG at SJGH. An interviewer-administered Additional file 1 was used, and dietary intake of sodium was calculated with food-frequency tables and web-based tools. A data extraction form was used and details regarding Coronary arterial segments with atheroma formation were obtained from angiogram reports. After exploring the normality, Spearman-correlation-coefficient and Mann-Whitney-U tests were used to explore associations of atheroma formation. Independent association of sodium-intake and Coronary arterial segments affected with atheroma was explored with multiple-logistic regression. ResultsThe sample was with a male preponderance(male to female ratio=3:1). Comorbidities were observed in a notable proportion: diabetes(47%), dyslipidemia(40%), hypertension(56%). The median(IQR) of BMI and waist circumference were 25.00(23.00-27.00)kg/m2 and 87.00(82.00-91.00)cm. The median(IQR) sodium-intake was 5875.50(4905.25-7091.25)mg. All participants (n=210) had a sodium intake of more than 2000mg/day. Sodium intake(rs=0.599,p<0.001) and BMI(rs=0.634,p=0.034) were significantly associated with atheroma segments whereas age, gender, diabetes, hypertension, dyslipidemia, waist circumference was not(p>0.05). Sodium intake was found to be an independent predictor of affecting “5 or more segments” when multiple logistic regression was applied(OR= 2.25,CI=1.41 to 3.61). Conclusions and RecommendationsThe daily intake of sodium by a regular person is more than the dietary recommendations in the study sample. Salt intake reflected by sodium intake seemingly increase the risk of atheroma formation in more coronary segments irrespective of age, sex as well as several known disease conditions and risk factors. More research must be promoted with analytical approaches in proving this hypothesis.