Maladies cardiovasculaires

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Magnesium, calcium, and potassium intake has been inversely related to blood pressure and hypertension in several observational studies,3-6 and some, though not all, randomized controlled trials have demonstrated reduction in blood pressure levels in persons receiving supplementation with these minerals alone or in combination.7-10 Sodium intake, however, has been positively associated with blood pressure, and there is evidence that reduced sodium intake leads to a modest reduction in blood pressure levels.11,12 Nevertheless, the question of whether magnesium, calcium, potassium, and sodium intake is associated with risk of stroke remains controversial. Results: There was no consistent association of urinary sodium, potassium, or sodium/potassium ratio with CVD and all-cause mortality over the range of intakes observed in this population. Diet was assessed at baseline using a validated self-administered food frequency questionnaire that included 276 food items and mixed dishes commonly consumed in Finland.14 The questionnaire was used with a portion-size color picture booklet of 122 photographs of foods, each with 3 to 5 different portion sizes. The salt used in cooking was included in the average recipes of mixed dishes as an ingredient, and the recipe file was used in all the nutrient calculations.

At baseline, participants completed a questionnaire on background characteristics and medical, smoking, and physical activity histories.13 Height, weight, and blood pressure levels were measured, and a blood sample was drawn and stored at −70°C. For the present analyses, we also excluded men with incomplete dietary data and those with a self-reported history of stroke at baseline, leaving 26 556 men for the analyses. We had dietary intake assessed only at baseline, which may have contributed to misclassification because of dietary changes during follow-up. Background A high intake of magnesium, calcium, and potassium and a low intake of sodium have been hypothesized to reduce the risk of stroke.

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In 18 of 28 patients, hemolysis, elevated liver enzymes, low platelets syndrome did not significantly alter blood pressures compared with non-hemolysis, elevated liver enzymes, low platelets. Results After adjustment for age and cardiovascular risk factors, a high magnesium intake was associated with a statistically significant lower risk of cerebral infarction but not with intracerebral or subarachnoid hemorrhages. Furthermore, the extensive information on cardiovascular risk factors allowed comprehensive adjustment for potential confounders, and the large number of cases provided high statistical power to detect associations. Multivariate models were further controlled for cardiovascular risk factors (alcohol intake, number of cigarettes smoked daily, body mass index, systolic and diastolic blood pressure levels, serum total and HDL cholesterol levels, histories of diabetes and coronary heart disease, and leisure-time physical activity) and total energy intake. All models were adjusted for age at baseline and supplementation group (α-tocopherol, beta carotene, or both or placebo). 05 for all). The multivariate RRs of cerebral infarction for the highest vs the lowest quintile of magnesium intake were 0.76 (95% CI, 0.64-0.89) among men younger than 60 years and 1.02 (95% CI, 0.84-1.23) among those 60 years and older.

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Baseline urinary samples were analyzed for sodium and potassium in 795 subjects who died, 206 with an incident myocardial infarction and 181 subjects with an incident stroke, and in 1,448 randomly selected subjects. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Hypertension et insuffisance rénale . Electrolytes and hypertension: results from recent studies. Background: Dietary electrolytes influence blood pressure, but their effect on clinical outcomes remains to be established. A recent meta-analysis of 12 randomized clinical trials showed that magnesium supplementation may slightly reduce diastolic blood pressure by 2.2 mm Hg.9 Therefore, a potential hypotensive effect of magnesium intake is small and could only partially explain the inverse association of magnesium intake with cerebral infarction. Potassium intake was also inversely associated with risk of cerebral infarction in our study, but this association was substantially weakened and did not remain in a multivariate model that simultaneously included magnesium and potassium. As in our study, no association between calcium intake and stroke was found in the Health Professionals Follow-up Study.30 The Nurses’ Health Study31 showed an inverse association between intake of calcium, especially dairy calcium, and stroke risk.

We further examined calcium intake from dairy and nondairy sources in relation to risk of stroke and found an inverse relationship between nondairy calcium and cerebral infarction (highest vs lowest quintile: multivariate RR, 0.86; 95% CI, 0.76-0.96). However, this association did not persist after further adjustment for intake of folate, vitamin C, vitamin E, saturated fat, polyunsaturated fat, and dietary fiber (RR, 0.96; 95% CI, 0.84-1.10). We considered the possibility that the effect of dietary magnesium, calcium, potassium, and sodium intake on stroke risk might be mediated through blood pressure and that adjustment for blood pressure in our multivariate models might minimize potential associations. We examined sodium and potassium intake in relation to cardiovascular disease (CVD) and mortality in an unselected older population. There are limited prospective data on magnesium intake in relation to risk of stroke. Although our dietary assessment provides valid estimates of dietary sodium intake on a group level, there may be misclassification on an individual level, which would lead to attenuation of the RR estimates toward the null. An advantage is the prospective design, which precluded the possibility for recall bias in the dietary assessment. The relatively long food frequency questionnaire (276 items) that was used to assess dietary intake in our population probably resulted in a slight overestimation of energy intake, whereas a shorter food frequency questionnaire and a 24-hour recall (eg, which were used in the National Health and Nutrition Examination Survey34) tend to result in an underestimation.

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The prevalence of diabetes and coronary heart disease was higher among men in the highest quintile of mineral intake than among those in the lowest quintile (Table 1). This difference probably reflects dietary changes after diagnosis of these diseases. Men were excluded from the trial if they (1) had a history of cancer (other than nonmelanoma skin cancer or carcinoma in situ) or other serious disease that might limit long-term participation; (2) received anticoagulant therapy; or (3) used vitamin E, vitamin A, or beta carotene supplements in excess of predefined doses. Furthermore, adjustment for baseline blood pressure had little effect on the estimated RR relating magnesium intake to cerebral infarction.

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Author Contributions: Dr Larsson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All nutrients were energy adjusted using the residual method.18 Magnesium, calcium, potassium, and sodium intake was categorized into quintiles based on the distribution among the study population. Tests for trend were conducted by assigning the medians of mineral intake in quintiles treated as a continuous variable. Effect modification was examined in stratified analyses and was statistically tested by including the cross-product term of the mineral variable (modeled as a continuous variable) and the effect modifier (as a dichotomous variable). Methods We examined the relationship of dietary magnesium, calcium, potassium, and sodium intake with risk of stroke in a cohort of 26 556 Finnish male smokers, aged 50 to 69 years, who were free from stroke at baseline. Findings from previous studies that have examined the relationship between sodium intake and stroke risk have been inconsistent. The intake of calcium from dietary supplements was negligible compared with total intake from diet19 and was therefore unlikely to have influenced the results.

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Gros Homme Mûr Mesurant Son Ventre Avec La Bande De Mesure.. Intake of calcium, potassium, and sodium was not significantly associated with risk of any stroke subtype after potential confounders were controlled for. Excluding systolic and diastolic blood pressure levels from the multivariate model did not materially alter the relationship between these minerals and risk of stroke (data not shown). Stop hypertension livre . Additional adjustment for dietary variables, including folate, vitamin C, vitamin E, fat, carbohydrate, protein, and fiber, did not change the results appreciably; therefore, these variables were not included in the main multivariate model. In this cohort, we previously found that the risk factor profiles of stroke subtypes differ.29 For example, serum total cholesterol concentrations were positively associated with risk of cerebral infarction only, and serum HDL cholesterol concentrations were inversely related to risk of cerebral infarction and subarachnoid hemorrhage but not to intracerebral hemorrhage.29 Therefore, if magnesium reduces stroke risk by influencing cholesterol concentrations or insulin resistance, the beneficial effect of high magnesium intake may be limited to cerebral infarction. While the biologic mechanism explaining this relationship is unclear, our findings suggest that a high consumption of magnesium-rich foods, such as whole-grain cereals, may play a role in the prevention of cerebral infarction.

Conclusion These findings in male smokers suggest that a high magnesium intake may play a role in the primary prevention of cerebral infarction. Tests based on Schoenfeld residuals and graphical methods using Kaplan-Meier curves21 showed no evidence that the proportional hazards assumption was violated. Values for the amounts of nutrients in the foods were based on the food composition database at the National Public Health Institute. Dietary intake was assessed at baseline using a detailed and validated food frequency questionnaire. Nutrient intake was calculated by multiplying the frequency of consumption of each food by the average nutrient content of the specified portion size. Each participant contributed person-time of follow-up from the date of randomization until the date of occurrence of first stroke, death, or December 31, 2004, whichever came first. During a mean follow-up of 13.6 years (1985-2004), 2702 cerebral infarctions, 383 intracerebral hemorrhages, and 196 subarachnoid hemorrhages were identified in the national registries. To address the potential for increased exposure misclassification over time, we divided the follow-up time into 5-year periods. The end point of the study was first-ever stroke that occurred between the date of randomization and December 31, 2004. Hypertension symptome . The strokes were further divided into cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and unspecified stroke.