Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Urine Sodium-to-Potassium Ratio Predicts Stroke

Stroke; ePub 2019 Jan 21; Averill, Young, et al

The spot urine sodium-to-potassium ratio (measurable in routine care) is associated with stroke, according to a recent study. Furthermore, a urine sodium-to-potassium ratio of ≤1, may be related to a clinically relevant reduction in stroke risk and is a feasible target for health interventions. The MESA, a prospective cohort study, consisted of 6,814 adults from 4 ethnic groups (European-, Asian-, African- and Hispanic-American) with a mean age of 62 (±10.2) years and an average of 11.7 (±2.2) years of follow-up. Participants were free of clinical cardiovascular disease at baseline. Spot urine sodium and potassium excretion, as a marker of dietary intake, was collected at baseline. The impact of urinary sodium-to-potassium ratio on adjudicated cardiovascular events was assessed using Cox proportional hazards models. Researchers found:

  • Only 39% of MESA participants had a urinary sodium-to-potassium ratio ≤1, and these participants experienced only 74 of the 236 strokes.
  • A sodium-to-potassium ratio >1 was associated with a hazard ratio of 1.47 for risk of stroke, adjusting for age, sex, race, cardiovascular risk factors, socio-demographic characteristics, body size, and kidney function.

Averill MA, Young RL, Wood AC, et al. Spot urine sodium-to-potassium ratio is a predictor of stroke. The MESA. [Published online ahead of print January 21, 2019]. Stroke. doi:10.1161/STROKEAHA.118.023099.