Scientific Reports (Apr 2018)

Association patterns of urinary sodium, potassium, and their ratio with blood pressure across various levels of salt-diet regions in China

  • Lu Yin,
  • Guijuan Deng,
  • Andrew Mente,
  • Yi Sun,
  • Xiaoyun Liu,
  • Xinhua Zhang,
  • Xingyu Wang,
  • Yang Wang,
  • Jian Bo,
  • Hui Chen,
  • Xu Liu,
  • Nan Gao,
  • Xiulin Bai,
  • Sumathy Rangarajan,
  • Wei Li

DOI
https://doi.org/10.1038/s41598-018-25097-1
Journal volume & issue
Vol. 8, no. 1
pp. 1 – 11

Abstract

Read online

Abstract We aim to evaluate the association of systolic and diastolic blood pressure (SBP and DBP) with estimated urinary sodium (Na) and potassium(K) excretions, and their gram-to-gram Na/K ratio across various salt-diet regions during 2005–2009 in China. A prospective cohort study was conducted to recruit 46,285 participants in China. A single fasting morning urine specimen was collected to estimate 24-hour urinary Na and K excretion using Kawasaki formula. Means of estimated Na and K were 5.7 ± 1.7 and 2.1 ± 0.5 grams/day, respectively, and mean estimated Na/K ratio was 2.8 ± 0.8. Adjusted analyses showed 1.70 mmHg SBP and 0.49 mmHg DBP increase per 1-g increment of estimated Na, while 1.10 mmHg SBP and 0.91 mmHg DBP decrease for one-gram increase of K. A significant increase in SBP (4.33 mmHg) and DBP (1.54 mmHg) per 1 unit increase in Na/K ratio was observed. More changes of SBP (4.39 mmHg) and DBP (1.67 mmHg) per one-unit increase of Na/K ratio were observed in low-salt regions, though significant changes were also found in moderate- and heavy-salt regions (P for heterogeneity < 0.01). Conclusively, decreasing sodium combined with increasing potassium is likely to have a more beneficial effect than decreasing sodium alone, even if those were living in low-salt regions.