Sodium-packed medications raise stroke and death risks

Where sodium lurks
It’s not just in prepared foods like spaghetti sauce. Sodium in soluble or fizzy forms of medications can add more than a recommended day’s worth of sodium intake, and those who take those medications are at higher risk of stroke and death, says a new study.
(Allen J. Schaben / Los Angeles Times)

Apparently, not all pills got the memo about, first, doing no harm. Many formulations of common medications contain high levels of sodium, and a new study finds that people who take those medications are 22% more likely to suffer a non-fatal stroke and 28% more likely to die of any cause than people who take the same medications in formulations that do not contain sodium.

Among the patients in the study who took medications containing sodium, the median daily sodium dose from those medicines  alone was 106.8 millimoles a day -- higher than recommended daily maximum dietary intake of 104 millimoles a day.

The newest study on sodium in medicines was published Tuesday in the British Medical Journal (BMJ).

Medicines that come in powdered, effervescent or soluble formulations tend to be particularly high in sodium, and researchers in London and Dundee, Scotland, collected a list of 24 drugs that were available in such formulations. Among them were effervescent or soluble versions of the pain relievers acetaminophen and aspirin, metoclopramide, taken to soothe stomach ulcers and gastrointestinal reflux, and calcium and zinc supplements.


They then combed through a computerized database of British medical records to follow 1,292,337 patients for an average of just over seven years. Their aim was to detect whether people who suffered cardiovascular “events” were more or less likely than those who did not to have taken medications high in sodium content.

In that time, 61,072 patients suffered a non-fatal stroke, heart attack or death attributable to vascular disease.

The researchers drew from the medical records to match those patients with control subjects similar in age, sex and health status. Then, they looked for a recent history of taking sodium-containing medications in both groups.

Those who suffered a stroke, a heart attack or vascular death were, on average 16% more likely to have taken high-sodium formulations of drugs than those who did not suffer such an outcome.


The authors of the study wrote that the public “should be warned about the potential dangers of high sodium intake from prescribed medicines.” They recommended that sodium-containing formulations should only rarely be prescribed when formulations without sodium exist.
They also call for the sodium content of medicines to be clearly labeled the same way that foods are labeled. That would be a change, since pharmaceutical manufacturers are not currently required to reveal the sodium content of their formulations.

High dietary sodium intake has been linked to hypertension and can reduce the effectiveness of medication for high blood pressure. Are any of your medications playing you with too much salt? Check the labels for references to sodium carbonite or bicarbonite: Those are clear give-aways.


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