Sodium intake 3-5 g per day plus potassium intake of 4.6 g per day, lowest risk of death

People consuming 3000 to 5000 mg of sodium per day plus a high potassium intake (greater than 4600 mg per day) had the lowest risk of death during an average follow-up of 8.2 years according to data from 103,5700 people from 18 countries.

People consuming more than 7000 mg of sodium per day were at a higher risk of death

People consuming more than 7000 mg of sodium per day were:

• 36% more likely to die
• 49% more likely to die from cardiovascular disease
• 76% more likely to have a fatal stroke

compared to people consuming 4000 to 5000 mg of sodium per day.

People consuming less than 3000 mg of sodium per day were at a higher risk of death

People consuming less than 3000 mg of sodium per day were

• 26% more likely to die
• 35% more likely to die from cardiovascular disease
• 24% more likely to have a fatal stroke

compared to people consuming 4000 to 5000 mg of sodium per day.

Potassium: 3500 mg of potassium excretion = 4600 mg of potassium intake

The paper talks about 3500 mg of potassium excretion per day, but they note that only about 75% of potassium is excreted in the urine, which means potassium intake would be greater than 4600 mg per day (3500 divided by 0.75 = 4666 mg).

This data does NOT support WHO’s recommendation to consume less than 2000 mg of potassium per day

The authors of the paper conclude that their data does NOT support the WHO’s recommendation to consume less than 2000 mg of sodium per day.

Their data argues against the use of the sodium-to-potassium ratio

Also of interest, they note that their data argues against the use of the sodium-to-potassium ratio.

Reference

O’Donnell M, Mente A, Rangarajan S, McQueen MJ, O’Leary N, Yin L, Liu X, Swaminathan S, Khatib R, Rosengren A, Ferguson J, Smyth A, Lopez-Jaramillo P, Diaz R, Avezum A, Lanas F, Ismail N, Yusoff K, Dans A, Iqbal R, Szuba A, Mohammadifard N, Oguz A, Yusufali AH, Alhabib KF, Kruger IM, Yusuf R, Chifamba J, Yeates K, Dagenais G, Wielgosz A, Lear SA, Teo K, and Yusuf S. Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study. BMJ, 2019 Mar 13; 364: l772.

Author’s Contact Info

Martin O’Donnell
Population Health Research Institute
DBCVS Research Institute
McMaster University
237 Barton St East
Hamilton, ON L8L 2X2, Canada
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Articles on the same subject can be found here:

• Heart Attack (myocardial infarction)

• Heart Disease

• Potassium

• Sodium Intake

• Stroke, hemorrhagic

• Stroke, ischemic