Sodium intake and risk of death from stroke in Japanese men and women

Background and Purpose - Despite the evidence for a positive association of dietary salt and blood pressure, the few prospective studies that have assessed the association between dietary salt and stroke have reported inconsistent results. The purpose of this study was to examine the relation between sodium intake and death from stroke in a population-based cohort of Japanese men and women. Methods - In 1992, usual diet including sodium intake was determined in 13 355 men and 15 724 women in Takayama City, Gifu, with the use of a validated food frequency questionnaire. Results - There were 269 stroke deaths ( 137 men and 132 women) between baseline and 1999. In men, the highest compared with the lowest tertile of sodium intake was significantly positively associated with death from total stroke after controlling for covariates ( hazard ratio [HR]), 2.33; 95% CI, 1.23 to 4.45). Significantly positive associations were also observed between sodium intake and death from ischemic stroke ( HR, 3.22; 95% CI, 1.22 to 8.53) as well as death from intracerebral hemorrhage ( HR, 3.85; 95% CI, 1.16 to 12.7). A positive association between sodium intake and death from stroke in women was suggested, although the associations for total stroke and ischemic stroke were of borderline significance ( HR, 1.70; 95% CI, 0.96 to 3.02 and HR, 2.10; 95% CI, 0.96 to 4.62, respectively). Conclusions - These prospective data support the hypothesis that dietary salt increases the risk of death from stroke.