Table 3.
Associations of Bicarbonate Concentration with Incident Cardiovascular Events and Heart Failure
| Hard Cardiovascular Event (N=331) | Adjusted Hazard Ratio (95% Confidence Interval) | |||
|---|---|---|---|---|
| Bicarbonate (mEq/L) | Number of Events | Model 1 | Model 2 | Model 3 |
| Diuretic Use | ||||
| < 21 | 3 | 0.95 (0.29 to 3.15) | 0.85 (0.25 to 2.89) | 0.90 (0.26 to 3.06) |
| 21–23 | 16 | 0.84 (0.47 to 1.50) | 0.93 (0.52 to 1.67) | 0.98 (0.54 to 1.77) |
| 23–24 | 39 | 1.00 (REF) | 1.00 (REF) | 1.00 (REF) |
| ≥ 25 | 24 | 0.56 (0.33 to 0.94) | 0.65 (0.85 to 1.05) | 0.71 (0.42 to 1.22) |
| Per 1 mEq/L higher | 0.92 (0.83 to 1.02) | 0.94 (0.85 to 1.05) | 0.95 (0.85 to 1.06) | |
| P-value* | 0.10 | 0.26 | 0.34 | |
| No Diuretic Use | ||||
| <21 | 13 | 0.70 (0.40 to 1.25) | 0.59 (0.33 to 1.06) | 0.59 (0.32 to 1.08) |
| 21–23 | 78 | 1.02 (0.76 to 1.37) | 0.98 (0.72 to 1.32) | 0.91 (0.66 to 1.24) |
| 23–24 | 114 | 1.00 (REF) | 1.00 (REF) | 1.00 (REF) |
| ≥ 25 | 44 | 0.97 (0.69 to 1.38) | 1.01 (0.71 to 1.44) | 1.02 (0.71 to 1.46) |
| Per 1 mEq/L higher | 1.02 (0.96 to 1.10) | 1.05 (0.98 to 1.13) | 1.06 (0.99 to 1.14) | |
| P-value* | 0.50 | 0.15 | 0.12 | |
| Heart Failure (N=174) | Adjusted Hazard Ratio (95% Confidence Interval) | |||
|---|---|---|---|---|
| Bicarbonate (mEq/L) | Number of Events | Model 1 | Model 2 | Model 3 |
| Diuretic Use | ||||
| < 21 | 3 | 1.32 (0.38 to 4.59) | 0.70 (0.19 to 2.59) | 0.91 (0.25 to 3.36) |
| 21–23 | 14 | 1.03 (0.54 to 1.95) | 1.01 (0.53 to 1.95) | 1.14 (0.59 to 2.21) |
| 23–24 | 29 | 1.00 (REF) | 1.00 (REF) | 1.00 (REF) |
| ≥ 25 | 13 | 0.38 (0.20 to 0.75) | 0.42 (0.21 to 0.84) | 0.47 (0.24 to 0.96) |
| Per 1 mEq/L higher | 0.83 (0.74 to 0.93) | 0.90 (0.79 to 1.01) | 0.88 (0.78 to 1.01) | |
| P-value* | 0.002 | 0.07 | 0.06 | |
| No Diuretic Use | ||||
| <21 | 7 | 0.86 (0.39 to 1.93) | 0.61 (0.26 to 1.43) | 0.65 (0.27 to 1.54) |
| 21–23 | 31 | 0.93 (0.60 to 1.45) | 0.83 (0.53 to 1.31) | 0.79 (0.49 to 1.26) |
| 23–24 | 51 | 1.00 (REF) | 1.00 (REF) | 1.00 (REF) |
| ≥ 25 | 26 | 1.26 (0.78 to 2.04) | 1.30 (0.80 to 2.11) | 1.23 (0.75 to 2.01) |
| Per 1 mEq/L higher | 1.08 (0.96 to 1.21) | 1.13 (1.01 to 1.26) | 1.12 (1.00 to 1.26) | |
| P-value* | 0.20 | 0.03 | 0.047 | |
Model 1: Adjusted for age, race/ethnicity, gender, education and MESA site
Model 2: Adjusted for covariates in model 1 plus diabetes, self-reported emphysema, body mass index, systolic blood pressure, smoking, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, eGFR, C-reactive protein, urine albumin to creatinine ratio, use of antihypertensive medications, use of lipid-lowering medications.
Model 3: Adjusted for covariates in model 2 plus dietary protein density. Interaction between diuretic use and bicarbonate examining incident heart failure (p-interaction = 0.03 in model 2 when bicarbonate was examined categorically and 0.003 in model 2 when bicarbonate was examined continuously).
P-value is for continuous comparison