Influence of Perceived Dietary Saltiness on Sudden Cardiac Arrest Incidence in Individuals with and without Diabetes Mellitus: A Case-Control Study.
Yonsei medical journal · 2025-11-25 · Observational study
Abstract
PURPOSE: While many studies have explored the association between habitual salt intake and the incidence of coronary artery disease, research on the relationship between saltiness level and sudden cardiac arrest (SCA) is limited. Therefore, this study aimed to investigate the association between perceived dietary saltiness and the risk of SCA, as well as whether this relationship is influenced by the presence of diabetes mellitus (DM). MATERIALS AND METHODS: We conducted a multicenter case-control study at 17 hospitals in Korea between September 2017 and December 2020. The cases involved patients with out-of-hospital cardiac arrest, aged 19-79 years, with a presumed cardiac cause. Community-based controls were matched 1:1 with cases based on age, sex, and level of urban residence. The primary exposure was perceived dietary saltiness. We used multivariable logistic regression to compare outcomes and included interaction terms in the final model to evaluate whether DM modified the effect of salt intake on SCA incidence. RESULTS: Multivariable conditional logistic regression analysis showed that a very salty diet was associated with an increased risk of SCA [adjusted odds ratio (AOR) (95% confidence interval, CI): 1.88 (1.12-3.16)] compared to a moderate salt intake. In the interaction analysis, the risk of SCA from a very salty diet was significantly higher only in individuals with DM [AOR (95% CI): 3.49 (1.74-5.55)], with no significant association in those without DM. CONCLUSION: A perceived high level of dietary saltiness was associated with an increased incidence of SCA in the general population; however, a significant association was observed only in individuals with DM.