Abstract: FR-PO559
The Association of Hyponatremia With Cognitive Function and All-Cause Mortality: A Post Hoc Analysis of the Systolic Blood Pressure Intervention Trial
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders
- 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical
Authors
- Sarwal, Amara, University of Utah Health, Salt Lake City, Utah, United States
- Boucher, Robert E., University of Utah Health, Salt Lake City, Utah, United States
- Abraham, Nikita, University of Utah Health, Salt Lake City, Utah, United States
- Singh, Ravinder, University of Utah Health, Salt Lake City, Utah, United States
- Ye, Xiangyang, University of Utah Health, Salt Lake City, Utah, United States
- Moghaddam, Farahnaz Akrami, University of Utah Health, Salt Lake City, Utah, United States
- Hartsell, Sydney Elizabeth, University of Utah Health, Salt Lake City, Utah, United States
- Wei, Guo, University of Utah Health, Salt Lake City, Utah, United States
- Beddhu, Srinivasan, University of Utah Health, Salt Lake City, Utah, United States
Background
Severe hyponatremia (hypoNa) needing treatment with hypertonic saline was associated with probable dementia (PD) in a retrospective study. It is unknown whether mild hyponatremia is a risk factor for mild cognitive impairment (MCI)/ PD.
Methods
The Systolic Blood Pressure Intervention Trial (SPRINT) MIND study (N= 8561) evaluated the effects of intensive systolic BP control (goa l< 120mmHg) vs. standard SBP control (goal < 140 mmHg) on risk of adjudicated MCI/PD. In this post-hoc secondary analysis, we included 8541 SPRINT-MIND participants with baseline serum Na > 130 meq/L and non-missing baseline and 6-months (6m) serum Na. We defined incident hypoNa as a serum Na < 130 mmol/L at m6 and related incident hypoNa with time to MCI alone, PD alone, a composite of MCI/PD and all-cause mortality (ACM) in separate Cox regression models adjusted for the SBP intervention, age, gender, race, CVD, CHF, smoking, BMI and eGFR.
Results
The mean baseline serum Na was 140 ± 2 meq/L. 129 (1.5%) participants developed incident hyponatremia at 6m with a mean serum sodium of 127±3 meq/L. Compared to those without incident hyponatremia, those with incident hyponatremia were in general, older, had lower BMI and more likely to be women, African-American, treated with thiazide diuretics and assigned to intensive SBP arm. The mean follow-up duration was 4.8 ± 1.4 yrs. There were 1254 MCI, 324 PD, 1485 MCI/PD and 324 ACM events. As shown in table incident hypoNa was not associated with MCI or MCI/PD composite but with higher risk of PD and ACM.
Conclusion
In this post hoc analysis of SPRINT, while hypoNa was not associated with subsequent MCI or MCI/PD, it was associated with PD and ACM.
| MCI | PD | MCI/PD | ACM | |
| Unadjusted | 0.84 (0.50, 1.43) | 2.46 (1.31, 4.61) | 1.17 (0.78, 1.77) | 1.64 (0.77, 3.46) |
| + SBP intervention, age, gender, race | 0.83 (0.49, 1.40) | 2.00 (1.06, 3.77) | 1.10 (0.73, 1.66) | 1.59 (0.75, 3.37) |
| + CVD, CHF, smoking, BMI, eGFR | 0.83 (0.49, 1.42) | 2.12 (1.12, 4.01) | 1.12 (0.74, 1.69) | 1.82 (0.85, 3.87) |