Ramberg E, Greve AM, Berg RMG, et al. - Given that asymptomatic aortic stenosis (AS) represents a frequent condition that may induce hyponatremia because of neurohumoral activation, researchers investigated whether hyponatremia heralds poor prognosis among patients experiencing asymptomatic AS. They also determined if AS in itself is related to elevated risk of hyponatremia. Participants were 1,677 people that had and annual plasma sodium measurements in the SEAS (Simvastatin and Ezetimibe in AS) trial; randomization of 1,873 asymptomatic patients with mild-moderate AS (maximal transaortic velocity 2.5 to 4.0 m/s) was done to receive simvastatin/ezetimibe combination vs placebo. The primary endpoint was all-cause death and secondary outcome was incident hyponatremia (P-Na + <137 mmol/L). In patients with AS, both prevalent and incident hyponatremia were shown to be associated with elevated mortality. The prevalence of hyponatremia was estimated to be around 4% and the incidence was approximately 2% per year, which was comparable to that of older adults without AS.