Ma Y, He FJ, Sun Q, et al. - By analyzing multiple 24-hour urine samples, it was found that higher sodium and lower potassium intakes were related to a higher cardiovascular risk, in a dose–response manner. Thus, decreasing sodium intake and increasing potassium intake from current levels may be backed.

• Individual-participant data from six prospective cohorts of generally healthy adults were analyzed; evaluation of sodium and potassium excretion was done using at least two 24-hour urine samples per participant.

• A total of 10,709 participants (mean (±SD) age of 51.5±12.6 years) were analyzed in whom a median study follow-up of 8.8 years revealed 571 cardiovascular events.

• Analyses that were controlled for confounding factors showed a higher cardiovascular risk in relation to higher sodium excretion, lower potassium excretion, and a higher sodium-to-potassium ratio (P≤0.005 for all comparisons).

• Comparing quartile 4 of the urinary biomarker (highest) with quartile 1 (lowest), estimated hazard ratios were 1.60, 0.69, and 1.62 for sodium excretion, potassium excretion, and sodium-to-potassium ratio, respectively.

• An 18% increment in cardiovascular risk (hazard ratio, 1.18) was observed in relation to each daily increment of 1,000 mg in sodium excretion, and an 18% reduction in risk (hazard ratio, 0.82) was noted in relation to each daily increment of 1,000 mg in potassium excretion.