Life Extension Magazine®

Take blood tests to  indentify the risks the body may have for heart attack or stroke

As We See It: Confirming What Was Discovered Decades Ago

Studies confirm that excess sodium and insufficient potassium increases cardiovascular risk. Life Extension® advocates for at-home blood pressure monitoring and comprehensive blood tests to identify risks before a cardiovascular event occurs.

By William Faloon.

William Faloon
William Faloon

It was not until 1912 that a cardiologist established that the narrowing of coronary arteries could cause chest pain (angina).1

Doctors today continue to debate the triggers of atherosclerosis that cause most heart attacks.

Research dating back many decades associates' diets high in sodium and low in potassium with increased cardiovascular risk.2-10

A study published in 2017 found that people with high sodium and low potassium dietary intake are 60% more likely to suffer an ischemic stroke.11

This finding was supported in 2022 by a study published in the New England Journal of Medicine that assessed sodium and potassium urinary excretion as a biomarker for sodium-potassium ingestion.12

The New England Journal of Medicine study evaluated 10,709 people over an 8.8-year period and found that:

  • Compared to those with the lowest urinary level of sodium excretion, people with the highest level of urinary sodium excretion were 60% more likely to suffer a cardiovascular event.
  • Those with the highest potassium urinary excretion compared with the lowest potassium excretion were 31% less likely to suffer a cardiovascular event defined as a fatal or nonfatal heart attack or stroke.
  • Patients with the highest to lowest sodium-to-potassium urinary excretion ratio (more sodium, less potassium) were 62% more likely to suffer a cardiovascular event.
  • With each unit increase in the sodium-to-potassium excretion ratio (more sodium and less potassium), cardiovascular risks increased 24%.

These data on cardiovascular risks is based on meticulous research. It represents powerful evidence about the deadly impact of excess sodium intake and less-than-optimal ingestion of potassium.

Yet it was largely overlooked by the media, and I fear much of the public.

The take home lesson is for most people to reduce sodium (salt) intake and ensure they are obtaining adequate potassium.

Stroke and heart attack remain leading causes of disability and death despite a wealth of accumulated knowledge.13,14

The encouraging news is that many manageable cardiovascular risk factors have been identified. The disappointing aspect is most people fail to aggressively correct their vulnerabilities towards atherosclerosis.

We at Life Extension® advocate for people to have an at-home blood pressure monitor to ensure 24-hour blood pressure control.

We also urge readers to have comprehensive blood tests to identify risk factors before they suffer a heart attack or stroke.

The 2022 study published in the New England Journal of Medicine strongly confirms what was identified decades ago about the lethal effects of excess sodium and insufficient potassium.

For longer life,

For Longer Life

William Faloon


  1. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations . 3rd ed. Boston: Butterworths Copyright © 1990, Butterworth Publishers, a division of Reed Publishing.; 1990.
  2. Okayama A, Okuda N, Miura K, et al. Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study. BMJ Open.2016;6(7):e011632.
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  7. Umesawa M, Iso H, Date C, et al. Relations between dietary sodium and potassium intakes and mortality from cardiovascular disease: the Japan Collaborative Cohort Study for Evaluation of Cancer Risks. Am J Clin Nutr. 2008Jul;88(1):195-202.
  8. Yang Q, Liu T, Kuklina EV, et al. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Arch Intern Med.2011Jul 11;171(13):1183-91.
  9. Arbeit ML, Nicklas TA, Berenson GS. Considerations of dietary sodium/potassium/energy ratios of selected foods. J Am Coll Nutr.1992Apr;11(2):210-22.
  10. Langford HG. Sodium-potassium interaction in hypertension and hypertensive cardiovascular disease. Hypertension.1991;17(1_supplement):I155.
  11. Willey J, Gardener H, Cespedes S, et al. Dietary Sodium to Potassium Ratio and Risk of Stroke in a Multiethnic Urban Population: The Northern Manhattan Study. Stroke.2017Nov;48(11):2979-83.
  12. Ma Y, He FJ, Sun Q, et al. 24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk. N Engl J Med.2022Jan 20;386(3):252-63.
  13. Available at: . Accessed May 22, 2023.
  14. Available at: . Accessed May 24, 2023.