Estimated salt intake and risk of atrial fibrillation in a prospective community-based cohort

Research output: Contribution to journalArticle


Introduction: Hypertension predisposes to atrial fibrillation (AF) – a major risk factor for ischaemic stroke. Since a high dietary salt consumption is associated with hypertension, we investigated the association between urinary sodium excretion as a marker for dietary sodium intake and risk of new-onset AF in community-dwelling adults. Method: The UK Biobank includes 40- to 69-year-old British residents recruited 2006–2010. Participants were divided into sex-specific quintiles according to 24-hour sodium excretion estimated based on spot samples with the Kawasaki equation. We excluded participants with AF at baseline. Cox regression adjusted for cardiovascular risk factors was used to assess associations with risk of AF, using the third quintile as reference. Results: A total of 257 545 women and 215 535 men were included. During up to 10 years' follow-up, 2221 women and 3751 men were diagnosed with AF. There was a tendency for an increased risk of AF in the lowest and highest quintiles of estimated daily salt intake in both women and men. In the fully adjusted model, significant associations were seen amongst men in the lowest and highest quintiles of sodium excretion (hazard ratio, HRQv1, 1.20; 95% CI, 1.08–1.32, P < 0.001, and HRQv5 1.15, 95% CI, 1.03–1.27, P = 0.011). Conclusion: We found evidence for a U-shaped association between estimated daily salt intake and AF risk amongst men. A suggestive J-shaped association in women was not statistically confirmed, but analyses were likely underpowered. Our results suggest that above a certain physiological minimum level progressively higher salt intake is associated with increasing risk of AF.


External organisations
  • Dalarna University
  • Karolinska Institutet
  • Mora lasarett
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Nutrition and Dietetics
  • Cardiac and Cardiovascular Systems


  • atrial fibrillation, blood pressure, dietary salt, hypertension, Kawasaki formulae, sodium excretion
Original languageEnglish
Pages (from-to)700-708
Number of pages9
JournalJournal of Internal Medicine
Issue number5
Early online date2020 Nov 19
Publication statusPublished - 2021 May 1
Publication categoryResearch