Release Date: 2/5/2014
Cardiovascular disease (CVD) is the leading cause of death in the United States and in New York City (NYC). Reduction in sodium intake is a national health priority to prevent and reduce the development of high blood pressure, a leading risk factor for cardiovascular disease.
The Heart Follow-up Study (HFUS) 2010, conducted by Abt SRBI for the NYC Department of Health and Mental Hygiene (DOHMH), was a surveillance project designed to assess the NYC population’s sodium intake using the gold standard measurement of 24-hour urine collection. Results were used to set the baseline sodium intake by NYC adults for the National Salt Reduction Initiative (NSRI). Study results were just published in the American Journal of Public Health.
The HFUS is a critical component in the evaluation of the NSRI, which aims to reduce population-level salt intake by 20 percent over five years through gradual reductions in the sodium content of packaged and restaurant food. The NSRI is a partnership of over 95 cities, states and national health organizations, coordinated by DOHMH.
The project used the NYC Community Health Survey (CHS), an annual telephone survey of approximately 10,000 adults, as the recruitment vehicle to identify participants for urine collection. Participants 18 years and older who met the eligibility criteria were recruited to assure a representative sample of adult New Yorkers and were offered a $100 incentive to participate. Urine samples (aliquot of 24-hour collection and spot urine in a random subset), blood pressure, and other physical body measures were collected during a brief visit to the participant’s home. Urine samples were sent to a collaborating laboratory for the analysis of sodium, potassium, creatinine, and albumin.
Participant recruitment started on April 1, 2010 and concluded on August 18, 2010. Lab analysis concluded on September 22, 2010. Recruitment rates for the HFUS were higher than expected with a 34.4% agreement rate. At the conclusion of data collection, 2,333 participants were recruited and 1775 24-hour and 556 spot urine samples were analyzed at the lab. Primary results from the 1,656 adults who provided valid urine samples have recently been published online in the American Journal of Public Health1.
The Heart Follow-up Study 2010 found:
The mean daily sodium intake was 3239 milligrams per day among adult New Yorkers, and that 81% of participants exceeded their recommended limit.
Sodium intake was higher in non-Hispanic blacks (3477 mg/d) and Hispanics (3395 mg/d) than in non-Hispanic whites (3066 mg/d; both P < .05).
Higher sodium intake was associated with higher blood pressure in adjusted models, and this association varied by race/ethnicity.
Higher sodium intake among non-Hispanic blacks and Hispanics than among whites was not previously documented in population surveys relying on self-report.
Results demonstrated the feasibility of 24-hour urine collection for the purposes of population-level surveillance of chronic disease risk factors.
Full information about the HFUS study including a full Methods Report and clinical protocol here.
1Sonia Y. Angell, Stella Yi, Donna Eisenhower, Bonnie D. Kerker, Christine J. Curtis, Katherine Bartley, Lynn D. Silver, and Thomas A. Farley. (2014). Sodium Intake in a Cross-Sectional, Representative Sample of New York City Adults. American Journal of Public Health. e-View Ahead of Print.