Serum Chloride Is an Independent Predictor of Mortality in Hypertensive Patients

Chloride (Cl) is the major extracellular anion in the body, accompanying sodium (Na), and is primarily derived from dietary sources. Data suggest that increased dietary Cl intake increases blood pressure, yet paradoxically, higher serum Cl appears associated with lower mortality and cardiovascular r...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2013-11, Vol.62 (5), p.836-843
Main Authors: McCallum, Linsay, Jeemon, Panniyammakal, Hastie, Claire E, Patel, Rajan K, Williamson, Catherine, Redzuan, Adyani Md, Dawson, Jesse, Sloan, William, Muir, Scott, Morrison, David, McInnes, Gordon T, Freel, Ellen Marie, Walters, Matthew, Dominiczak, Anna F, Sattar, Naveed, Padmanabhan, Sandosh
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Chlorides - blood
Female
Follow-Up Studies
Humans
Hypertension - blood
Hypertension - mortality
Longitudinal Studies
Male
Medical sciences
Middle Aged
Proportional Hazards Models
Risk Factors
Scotland - epidemiology
Sodium Chloride, Dietary
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Summary:Chloride (Cl) is the major extracellular anion in the body, accompanying sodium (Na), and is primarily derived from dietary sources. Data suggest that increased dietary Cl intake increases blood pressure, yet paradoxically, higher serum Cl appears associated with lower mortality and cardiovascular risk. This implies that serum Cl also reflects risk pathways independent of blood pressure, serum Na, and bicarbonate (HCO3). We analyzed 12 968 hypertensive individuals followed up for 35 years, using Cox proportional hazards model to test whether baseline serum Cl was an independent predictor of mortality. To distinguish the effect of Cl from Na and HCO3, we adjusted for these electrolytes and also performed the analysis stratified by Na/HCO3 and Cl levels. Generalized estimating equation was used to determine the effect of baseline Cl on follow-up blood pressure. The total time at risk was 197 101 person-years. The lowest quintile of serum Cl (135 and Cl>100 had the best survival, and compared with this group, the Na>135 and Cl
ISSN:0194-911X
1524-4563
DOI:10.1161/HYPERTENSIONAHA.113.01793