Presentation on theme: "Overview of recent observational study on vascular event and sodium"— Presentation transcript:
1 Overview of recent observational study on vascular event and sodium 2016.Overview of recent observational study on vascular event and sodium박정배 (단국의대 제일병원 내과)
2 Contents:Observational study on Sodium intake 와 혈압과의 위험Large international Cohort studiesSodium intake 측정 방법의 장단점Future Research기존 Data 활용: KMetS
3 Observational study on Sodium intake 와 혈압과의 위험 Forest plot for changes in blood pressure per 1 g/d increase in sodium excretion.. Ref Martin O’Donnell et al. Circ Res 2016;116:1046~1057
4 Association between sodium intake and blood pressure by potassium intake groups (PURE study). Ref Martin O’Donnell et al. Circ Res 2016;116:1046~1057
5 Large international Cohort studies Estimated 24-hour urinary excretion of sodium and composite of cardiovascular (CV) death, stroke, myocardial infarction and hospitalization for congestive heart failure
6 Relationship of risk and sodium intake, showing the location of the 3 principal dietary reference intakes.
7 Relationship of risk and sodium intake Relationship of risk and sodium intake. Estimated 24-hour urinary excretion of sodium and composite of CV death, stroke, myocardial infarction and hospitalization for congestive heart failure (primary prevention cohort, Population Urban Rural Epidemiology [PURE] study).
8 Sodium intake 측정 방법의 장단점 AdvantagesDisadvantagesDietary survey methodsLow to moderate burdenDifficult to accurately assess the amount of sodium added or lost during cooking and eatingSimultaneous measurement of other nutrients and energyInaccurate or incomplete food consumption tables and use of different tables between countriesAvailable in a large population surveyReporting and coding errorsVariable content in manufactured or processed foodsHigh intra-observer and inter-observer variabilityVariable food culture24-hour urine collection methodEnables comparison with other countriesHigh burdenIndependent of cooking and eating habits, and food cultureDependency on the season and weatherLow intra-observer and inter-observer variabilityIncomplete collectionLow inter-survey variabilityDependency on the physical condition or renal functionSpot urine methodEasyDependency on the time of collectionConvenientInaccuracy of the calculation formulaCan be used easily in daily clinical practice and mass survey
9 K– MetS STUDY [summary] yr F/U endedHypertensive patients2014.3Q Final reportenroll month year yearVisit 1Visit 2Visit 3Spot urineNa/K/CrDegree of BPMetabolic syndromeRisk elements- obesity- age- Dyslipidemia- Prediabetes- comorbidityIncidence of diabetesIncidence ofcardiovascular diseaseEarly blood pressure controlControlling metabolic syndromeHome BP clinic BPInsulin resistance/DMCV events
11 Figure 1. Study Population – BP arm K-13/1/2017Figure 1. Study Population – BP armEnrollment : N = 10,732593 hospitals, Oct 2011 ~ Dec 2012Screening failure : 131(Consent withdrawn) Baseline : N = 10,601HBP (n=6,171)Patients excluded : 2,8763 Month: N = 7,725HBP (n=2,991)Patients excluded : 1,326HBP,home BP1 Year: N = 6,399HBP (n= 1,892)
12 Study population II : N = 5,315 K-13/1/2017Fig 2. Study Population – MetS armEnrollment : N = 10,732593 hospitals, Oct 2011 ~ Dec 2012Screening failure : 131(Consent withdrawn) Inclusion IData for Metabolic Syndromeat baseline and 3 M F/UData set I : N = 10,601Inclusion IIData for ACR at baseline,3 M and 1Y F/UData set II : N = 5,748Study population I : N = 5,481Exclusion: 166Patients with SBP<130 and DBP<85Study population II : N = 5,315
13 Future Research 우리나라에서 소디움 섭취와 위험인자, 심혈관 위험 발생과의 관계 정립 다양한 군에서 소디움에 대한 영향을 조사해서 어떤 군에서 소디움에 취약할 것인지 규명소디움에 취약한 군 대상으로 소량 및 중간 정도의 소디움 섭취 감소에 따른 심 혈관 위험인자에 대한 무작위 임상연구가 필요하고 또 그 중간 단계의 생리적 지표에 대한 변화를 찾는 것도 필요소디움 섭취에 따른 고혈압 약물에 대한 반응