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Serum chloride is an independent predictor of mortality in hypertensive patients

re: hypertension

Real science is never settled, and anyone who has certainty on such things is not qualified to discuss it.

Chloride is never mentioned in any mainstream article on cardiovascular disease or hypertension from what I’ve seen.

Serum chloride is an independent predictor of mortality in hypertensive patients


Chloride (Cl−) is the major extracellular anion in the body, accompanying sodium (Na+), and is primarily derived from dietary sources. Data suggest that increased dietary Cl− intake increases blood pressure, yet paradoxically, higher serum Cl− appears associated with lower mortality and cardiovascular risk. This implies that serum Cl− also reflects risk pathways independent of blood pressure, serum Na+, and bicarbonate (HCO3−)...

...In a large cohort of 12 968 hypertensive patients followed up for 35 years, serum Cl− <100 mEq/L was an independent predictor of all-cause mortality as well as both CVD and non-CVD mortality and this association was independent of concomitant serum Na+ and HCO3− levels and diuretic use....

Although serum Cl− is part of the standard screening biochemistry panel in outpatient clinics and is routinely measured in hypertensive patients, it does not feature in routine risk stratification. Our data would suggest that serum Cl− is a risk marker, and this is supported by other studies...

The mechanism by which low serum Cl− increases mortality is unclear...

...Serum Cl− is a marker of risk that appears to be dissociated from serum Na+ and HCO3− levels. The underlying mechanism for this risk is unclear. A simple explanation would be that serum Cl− reflects abnormal physiology better than serum Na+, levels of which are perhaps more homeostatically regulated than Cl−.

If other studies validate and extend our findings, further studies are now necessary to elucidate the underlying mechanisms involved in the association of low serum Cl− levels with mortality outcomes. However, as Cl− measurement is part of routine clinical screening, our results are potentially translatable into clinical practice to identify high-risk hypertensive patients. In view of the inverse linear association between serum chloride level <100 mEq/L and mortality, the normal lower limit of the reference range for serum chloride may be redefined from 95 mEq/L to 100 mEq/L.

WIND: where does this finding stand out there in the doctor community? Probably just ignored, as I’ve never had any doctor mention it.

I know from past blood work that my serum Chloride has been in the range of 102 to 108, which seems to be in safe territory (range 98-110). But a range does not mean optimal. In a year when I was in peak fitness and feeling great, it was 107. OTOH, an emergency room visit in Dec 2021, my potassium was out of range low (3.3, range 3.5-5.1) while chloride was 108. Electrolytes also need to be in balance.

See also:

Garlic, the ‘King of Cancer Prevention’

Aged Garlic Extract Retards Progression of Coronary Artery Calcification

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