Abstract
Introduction: Higher urinary excretion of sodium and albumin, and lower urinary excretion of potassium, is associated with adverse cardiovascular (CV) events. The differences in 24h urinary sodium, potassium, and albumin between non-Hispanic Black (NHB) and NH White (NHW) individuals and their association with AHA Life Simple 7 metrics of ideal CV health (CVH) is unknown. Methods: We evaluated the 2014 National Health and Nutrition Survey restricted data to determine the 1) 24h urinary measures (sodium, potassium, and albumin) excretion in NHB and NHW participants, 2) association of urinary measures with ideal CVH and 3) their relative contribution to ideal CVH differences between racial groups. Multivariable-adjusted logistic regression analysis was performed to assess the association of 24h urinary measures with ideal CVH. Mediation analysis was used to determine the effect of 24h urinary measures on observed racial differences in ideal CVH. Results: Among 429 participants (mean age: 42.6 years, 61% NHB), the 24h urinary sodium, potassium, and albumin excretion were 256.7 (95% CI: 221.4-292.0) mg/dL, 134.8 (113.5-156.1) mg/dL, and 20.9 (3.5-38.3) mg/dL, respectively, in NHB individuals. In NHW individuals, the 24-hour urinary sodium, potassium, and albumin excretion were 209.4 (189.4-229.4) mg/dL, 135.0 (124.3-145.7) mg/dL, 22.9 (2.48-48.3) mg/dL, respectively. NHB individuals had lower odds of having ideal CVH (0.35 [0.21-0.60]). Higher 24h urinary sodium excretion was the only urinary measure associated with lower odds of ideal CVH (0.99 [0.99-1.00]; p=0.027). There was no interaction by race for the association of 24-hour urinary measures with ideal CVH. 24h urinary sodium mediated 25.5% (14.8-74.0%) of the association between race and ideal CVH. Conclusions: We present the race-stratified normative data for 24h urinary measures among American adults without CV disease and highlight the association of 24h urinary sodium with ideal CVH.
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