Wenjin Liu1, Xiaoqin Huang2, Xuebing Liu3, Lulu Wang2, Zhensen Chen1, Dakota Ortega1, Li Chen4, Jie Sun1, Thomas S Hatsukami5, Chun Yuan1, Haige Li6, Junwei Yang7. 1. Department of Radiology, University of Washington, Seattle, WA, USA. 2. Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# Zhongshan North Road, Nanjing, Jiangsu, China. 3. Department of Radiology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan, Nanjing, Jiangsu, China. 4. Electrical and Computer Engineering, University of Washington, Seattle, WA, USA. 5. Department of Surgery, Division of Vascular Surgery, University of Washington, Seattle, WA, USA. 6. Department of Radiology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan, Nanjing, Jiangsu, China. lihaige999@126.com. 7. Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, 262# Zhongshan North Road, Nanjing, Jiangsu, China. jwyang@njmu.edu.cn.
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.
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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