Restricting Daily Salt Consumption Lowers AF Risk in Vulnerable Adults: Daily Dose

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On July 16, 2024, we reported on findings from a study published in JAMA Network Open that examined the association between sodium intake and incident atrial fibrillation (AF) in individuals with vascular disease.

The study

A total of 27 391 participants with vascular disease or high-risk diabetes enrolled in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (TRANSCEND) multicenter, randomized clinical trials were included in the current study.

Estimated daily sodium intake was obtained from fasting morning urine samples and the primary outcome was incident AF.

The findings

After multivariable adjustment, investigators observed a J-shaped association between sodium intake and AF risk. Consuming 8 g/day or more (3% of participants) was significantly associated with a 32% increased risk of incident AF (HR 1.32, 95% CI 1.01-1.74) compared with sodium intake of 4 to 5.99 g/day.

Sodium intake of 6 g/day or more, consumed by 19.1% of participants, was associated with a 10% increased AF risk per additional 1-g/day sodium intake (HR 1.10, 95% CI 1.03-1.18), but with no further lowering of AF risk at lower levels of sodium intake. For adults whose daily intake of sodium exceeded 8 g/day, results showed a statistically significant 32% increase in risk for AF.

Authors' comment

"These findings suggest that lowering sodium intake for AF prevention is best targeted at individuals who consume high sodium diets exceeding 6 g per day."

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