Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years

Abstract The direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h...

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Autores principales:	Xiaofu Du, Le Fang, Jianwei Xu, Xiangyu Chen, Yamin Bai, Jieming Zhong
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b6d47bddadde489f9b05a8f502704c54
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spelling	oai:doaj.org-article:b6d47bddadde489f9b05a8f502704c542021-12-02T14:26:55ZAssociation between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years10.1038/s41598-021-83049-82045-2322https://doaj.org/article/b6d47bddadde489f9b05a8f502704c542021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83049-8https://doaj.org/toc/2045-2322Abstract The direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h urinary sodium and potassium excretion among Chinese adults. A total of 1424 provincially representative Chinese residents aged 18 to 69 years participated in a cross-sectional survey in 2017 that included demographic data, physical measurements and 24-h urine collection. In this study, the average 24-h urinary sodium and potassium excretion and sodium-to-potassium ratio were 3811.4 mg/day, 1449.3 mg/day, and 4.9, respectively. After multivariable adjustment, each 1000 mg difference in 24-h urinary sodium excretion was significantly associated with systolic BP (0.64 mm Hg; 95% confidence interval [CI] 0.05–1.24) and diastolic BP (0.45 mm Hg; 95% CI 0.08–0.81), and each 1000 mg difference in 24-h urinary potassium excretion was inversely associated with systolic BP (− 3.07 mm Hg; 95% CI − 4.57 to − 1.57) and diastolic BP (− 0.94 mm Hg; 95% CI − 1.87 to − 0.02). The sodium-to-potassium ratio was significantly associated with systolic BP (0.78 mm Hg; 95% CI 0.42–1.13) and diastolic BP (0.31 mm Hg; 95% CI 0.10–0.53) per 1-unit increase. These associations were mainly driven by the hypertensive group. Those with a sodium intake above about 4900 mg/24 h or with a potassium intake below about 1000 mg/24 h had a higher risk of hypertension. At higher but not lower levels of 24-h urinary sodium excretion, potassium can better blunt the sodium-BP relationship. The adjusted odds ratios (ORs) of hypertension in the highest quartile compared with the lowest quartile of excretion were 0.54 (95% CI 0.35–0.84) for potassium and 1.71 (95% CI 1.16–2.51) for the sodium-to-potassium ratio, while the corresponding OR for sodium was not significant (OR, 1.28; 95% CI 0.83–1.98). Our results showed that the sodium intake was significantly associated with BP among hypertensive patients and the inverse association between potassium intake and BP was stronger and involved a larger fraction of the population, especially those with a potassium intake below 1000 mg/24 h should probably increase their potassium intake.Xiaofu DuLe FangJianwei XuXiangyu ChenYamin BaiJieming ZhongNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Xiaofu Du Le Fang Jianwei Xu Xiangyu Chen Yamin Bai Jieming Zhong Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years
description	Abstract The direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h urinary sodium and potassium excretion among Chinese adults. A total of 1424 provincially representative Chinese residents aged 18 to 69 years participated in a cross-sectional survey in 2017 that included demographic data, physical measurements and 24-h urine collection. In this study, the average 24-h urinary sodium and potassium excretion and sodium-to-potassium ratio were 3811.4 mg/day, 1449.3 mg/day, and 4.9, respectively. After multivariable adjustment, each 1000 mg difference in 24-h urinary sodium excretion was significantly associated with systolic BP (0.64 mm Hg; 95% confidence interval [CI] 0.05–1.24) and diastolic BP (0.45 mm Hg; 95% CI 0.08–0.81), and each 1000 mg difference in 24-h urinary potassium excretion was inversely associated with systolic BP (− 3.07 mm Hg; 95% CI − 4.57 to − 1.57) and diastolic BP (− 0.94 mm Hg; 95% CI − 1.87 to − 0.02). The sodium-to-potassium ratio was significantly associated with systolic BP (0.78 mm Hg; 95% CI 0.42–1.13) and diastolic BP (0.31 mm Hg; 95% CI 0.10–0.53) per 1-unit increase. These associations were mainly driven by the hypertensive group. Those with a sodium intake above about 4900 mg/24 h or with a potassium intake below about 1000 mg/24 h had a higher risk of hypertension. At higher but not lower levels of 24-h urinary sodium excretion, potassium can better blunt the sodium-BP relationship. The adjusted odds ratios (ORs) of hypertension in the highest quartile compared with the lowest quartile of excretion were 0.54 (95% CI 0.35–0.84) for potassium and 1.71 (95% CI 1.16–2.51) for the sodium-to-potassium ratio, while the corresponding OR for sodium was not significant (OR, 1.28; 95% CI 0.83–1.98). Our results showed that the sodium intake was significantly associated with BP among hypertensive patients and the inverse association between potassium intake and BP was stronger and involved a larger fraction of the population, especially those with a potassium intake below 1000 mg/24 h should probably increase their potassium intake.
format	article
author	Xiaofu Du Le Fang Jianwei Xu Xiangyu Chen Yamin Bai Jieming Zhong
author_facet	Xiaofu Du Le Fang Jianwei Xu Xiangyu Chen Yamin Bai Jieming Zhong
author_sort	Xiaofu Du
title	Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years
title_short	Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years
title_full	Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years
title_fullStr	Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years
title_full_unstemmed	Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years
title_sort	association between 24-h urinary sodium and potassium excretion and blood pressure among chinese adults aged 18–69 years
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b6d47bddadde489f9b05a8f502704c54
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Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years

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