Nutrition, Metabolism & Cardiovascular Diseases (2016) 26, 12e19

Available online at www.sciencedirect.com

Nutrition, Metabolism & Cardiovascular Diseases journal homepage: www.elsevier.com/locate/nmcd

Mild hyponatremia, hypernatremia and incident cardiovascular disease and mortality in older men: A population-based cohort study S.G. Wannamethee a,*, A.G. Shaper a, L. Lennon a, O. Papacosta a, P. Whincup b a b

Department of Primary Care and Population Health, UCL, London, UK Department of Population Health Sciences and Education, St George’s, University of London, UK

Received 12 March 2015; received in revised form 2 July 2015; accepted 21 July 2015 Available online 5 August 2015

KEYWORDS Serum sodium; Cardiovascular disease; Stroke; Mortality

Abstract Aim: To examine the association between serum sodium concentration and incident major cardiovascular disease (CVD) outcomes and total mortality in older men. Methods and Results: A prospective study of 3099 men aged 60e79 years without a history of cardiovascular disease followed up for an average 11 years during which there were 528 major CVD events (fatal coronary heart disease [CHD] and non-fatal MI, stroke and CVD death) and 873 total deaths. A U shaped relationship was seen between serum sodium concentration and major CVD events and mortality. Hyponatremia (