Abstract
This review aims to examine the relationship of sodium and potassium intake and cardiovascular disease (CVD) among older people. Methods: We performed a literature search using PubMed and Web of Science (January 2015 to July 2020) without language restriction. Observational and experimental studies that reported the relationship between sodium, potassium, or sodium-to-potassium ratio with CVD among older adults aged higher than 60 years were included. The authors independently screened all identified studies, extracted information, and assessed the quality of included studies. Risk of bias was assessed using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) for observational studies and the revised Cochrane risk-of-bias tool (RoB 2 tool) for randomized trials. Results: We included 12 studies (6 prospective cohort studies, 5 cross-sectional studies, and 1 experimental study). Five of the studies reported on sodium-to-potassium ratio (n = 5), and the others on potassium and/or sodium intake. Cardiovascular events (e.g., stroke and heart failure) were the most reported outcome (n = 9). Of the 12 studies included, five observational studies had low bias risk and the randomized controlled trial was judged as uncertain risk of bias. We found inconsistent results for the effect of the reduction of sodium intake in this population for lower risk of CVD. We found that both the increase of potassium intake and the decrease of sodium-to-potassium ratio were associated with lower risk of hypertension and CVD, particularly stroke. Conclusion: The present review suggests that both higher potassium and lower sodium-to-potassium ratio are associated with lower risk of CVD.
Highlights
The world is facing a critical healthcare challenge in rising and potentially unsustainable healthcare costs, mainly due to the increasing prevalence of unhealthy lifestyles, chronic diseases, and a growing ageing population that requires more diversified care and increased societal demands [1,2].the number of older persons (>60 years) in world is expected to double until 2050, when it is projected to reach nearly 2.1 billion of persons; the process of population ageing will be most advanced in Europe and North America [1]
The search was performed by one author (CG) using a combination of MeSH terms and keywords related to population, cardiovascular diseases (CVD), and dietary sodium and potassium intake, with no restriction on language
We found inconsistent results that supports the recommendation to reduce sodium intake in this population, we found strong evidence to support the increase of potassium intake and the decrease of sodium-to-potassium ratio in reducing the risk of hypertension and CVD, stroke
Summary
The world is facing a critical healthcare challenge in rising and potentially unsustainable healthcare costs, mainly due to the increasing prevalence of unhealthy lifestyles, chronic diseases, and a growing ageing population that requires more diversified care and increased societal demands [1,2].the number of older persons (>60 years) in world is expected to double until 2050, when it is projected to reach nearly 2.1 billion of persons; the process of population ageing will be most advanced in Europe and North America [1]. The world is facing a critical healthcare challenge in rising and potentially unsustainable healthcare costs, mainly due to the increasing prevalence of unhealthy lifestyles, chronic diseases, and a growing ageing population that requires more diversified care and increased societal demands [1,2]. It will be essential for countries to develop and implement policies to face an ageing population with a high burden of chronic conditions, including cardiovascular diseases (CVD). On top of health-related age frailty, ageing people have non-communicable chronic diseases such as CVD that are the main contributors to the total burden of disease and mortality in low-, middle- and high-income countries [3,4]. CVD imposes a huge burden in terms of mortality, morbidity, disability, functional decline, and healthcare costs [6]
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