Two UK cohort studies among individuals with and without high blood pressure (HBP) found that the initiation of sodium-containing acetaminophen was associated with a significant higher risk of incident cardiovascular disease (CVD, including myocardial infarction, stroke, and heart failure) and all-cause mortality than non-sodium-containing acetaminophen. The studies used marginal structural models with an inverse probability weighting to adjust for time-varying confounders. Among individuals with HBP (mean age: 73.4 years), 122 CVDs occurred among 4532 initiators of sodium-containing acetaminophen (1-year risk: 5.6%) and 3051 among 146 866 non-sodium-containing acetaminophen initiators (1-year risk: 4.6%). The average weighted hazard ratio (HR) was 1.59. Among individuals without HBP (mean age: 71.0 years), 105 CVDs occurred among 5351 initiators of sodium-containing acetaminophen (1-year risk: 4.4%) and 2079 among 141 948 non-sodium-containing acetaminophen initiators (1-year risk: 3.7%), with an average weighted HR of 1.45. Results of specific CVD outcomes and all-cause mortality were similar. There was a dose–response relationship between the number of sodium-containing acetaminophen prescriptions and the risk of CVD. Excessive sodium intake is a major public health concern globally. In addition to dietary sodium intake, sodium is widely used in drug preparations for enhancing solubility or disintegration. The effervescent and soluble formulations of 0.5 g acetaminophen contain 0.44 and 0.39 g of sodium, respectively. The findings suggest that individuals should avoid unnecessary excessive sodium intake through sodium-containing acetaminophen use. Source: https://academic.oup.com/eurheartj/
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