scholarly journals 809Sodium/potassium ratio change was associated with blood pressure change: finding from health check-up data

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Mana Kogure ◽  
Naoki Nakaya ◽  
Takumi Hirata ◽  
Naho Tsuchiya ◽  
Tomohiro Nakamura ◽  
...  

Abstract Background The sodium (Na)/potassium (K) ratio was reported to be associated with blood pressure (BP). Recently, the Na/K ratio self-monitoring device using spot urine was established. We assessed whether the urinary Na/K ratio change measured using the Na/K device was positively associated with BP change in a health check-up setting. Methods We targeted 12,890 participants who attended the annually health check-up in Tome City, Miyagi Prefecture, Japan between 2017 and 2018. Tome city introduced urinary Na/K ratio measurement during health check-up since 2017. We assessed the relationship between change in urinary Na/K ratio and BP change using multiple regression analyses adjusted for age, sex, and change in body mass index (BMI) and alcohol intake. For each year, we compared the baseline characteristics according to the urinary Na/K ratio and BP level. Results The change in systolic BP and diastolic BP was positively associated with the change in urinary Na/K ratio. The average urinary Na/K ratio was significantly lower in 2018 than in 2017 (5.4±3.0 to 4.9±2.2, p < 0.01). Moreover, their systolic BP in 2018 (130.9±17.4 mmHg) was lower than that in 2017 (132.1±17.9 mmHg) (p < 0.01). Conclusions The positive association of change in urinary Na/K ratio with hypertension and change in systolic and diastolic BP can be explained by a change in alcohol intake, BMI, and urinary Na/K ratio. Key messages Measuring the urinary Na/K ratio in community settings is a potential population approach for counteracting hypertension.

Author(s):  
Mana Kogure ◽  
Naoki Nakaya ◽  
Takumi Hirata ◽  
Naho Tsuchiya ◽  
Tomohiro Nakamura ◽  
...  

Abstract Recently, the sodium (Na)/potassium (K) ratio was reported to be associated with blood pressure (BP). A Na/K ratio self-monitoring device using spot urine was established recently. Here, we assessed whether the urinary Na/K ratio change measured using the Na/K device was associated with BP change in a health checkup setting. We targeted 12,890 participants who attended the health checkup in Tome City, Miyagi between 2017 and 2018. Tome City introduced urinary Na/K ratio measurements during health checkups since 2017. For each year, we compared the baseline characteristics according to the urinary Na/K ratio and BP level. We assessed the relationship between change in urinary Na/K ratio and BP change using multiple regression analyses adjusted for age, sex, and change in body mass index (BMI) and alcohol intake. The average urinary Na/K ratio was significantly lower in 2018 than in 2017 (5.4 ± 3.0 to 4.9 ± 2.2, P < 0.01). The systolic BP of the participants in 2018 (130.9 ± 17.4 mmHg) was lower than that in 2017 (132.1 ± 17.9 mmHg). Moreover, the change in systolic BP and diastolic BP was positively associated with the change in urinary Na/K ratio. In conclusion, the association of the change in urinary Na/K ratio with hypertension and changes in systolic and diastolic BP can be explained by a change in alcohol intake, BMI, and urinary Na/K ratio. Therefore, measuring the urinary Na/K ratio in community settings is a potential population approach for counteracting hypertension.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mana Kogure ◽  
Tomohiro Nakamura ◽  
Naho Tsuchiya ◽  
Takumi Hirata ◽  
Akira Narita ◽  
...  

Introduction: Recently, the balance between sodium and potassium intake, i.e. sodium-to-potassium (Na/K) ratio, has received significant attention for prevention of hypertension. Previous studies reported the positive association between urinary Na/K (uNa/K) ratio and hypertension. However, even the same uNa/K ratio value, there might be high Na/ high K ratio or low Na/ low K ratio. Hypothesis: We assessed the hypothesis that blood pressure (BP) is higher in high Na/ high K group than that in low Na/ low K group even at the same uNa/K ratio in general population in cross-sectional study. Methods: The subjects were 20 to 74 years old who participated in The Tohoku Medical Megabank Project Community-based Cohort Study. Of these participants, we targeted 54,011 subjects (men: 20,505 women: 33,506 mean age: 59.9 years) who had information of BP, urinary Na and K. We estimated 24-h urinary excretion of Na and K using Tanaka formula. Urinary Na and K were each classified into quartiles (Na; Q1~Q4, K; Q1~Q4), and set all 16 groups of uNa/K ratio by combining Na and K respectively. To assess the relationship between casual uNa/K ratio and BP, we performed an analysis of covariance to calculate the adjusted mean systolic BP (SBP). We included covariate factors as age, sex, BMI and alcohol intake. We also assessed the relationship between uNa/K ratio and SBP using multiple regression analyses adjusted for covariate factors. We stratified the participants into two groups: ‘under treatment for hypertension’ (n=17,091) and ‘without treatment for hypertension (n=36,920)’. Results: The mean of uNa/K ratio for each group of Na (Q1)/K(Q1), Na (Q2)/K(Q2), Na (Q3)/K(Q3) and Na (Q4)/K(Q4) was all 4.0. As previous report showed, higher uNa/K ratio group showed higher SBP and lower uNa/K group showed lower BP. When we compared adjusted mean SBP of Na (Q1)/K(Q1) and Na (Q4)/K(Q4) the value were comparable, but the value were significantly higher in Na (Q4)/K(Q4) group (The adjusted mean SBP of Na (Q1)/K(Q1), Na (Q2)/K(Q2), Na (Q3)/K(Q3) and Na (Q4)/K(Q4) was 123.6, 124.9, 124.7 and 125.5 mmHg, respectively). The uNa/K was significantly positively associated with SBP independently of age, sex, BMI, and alcohol intake. The finding was unchanged the results in under treatment group. Conclusions: BP was significantly higher in high Na/ high K group than in low Na/ low K group even at the same uNa/K ratio. We suggested that not only increasing K intake but also reducing salt is important for preventing hypertension.


2019 ◽  
Vol 43 (1) ◽  
pp. 62-71 ◽  
Author(s):  
Mana Kogure ◽  
Takumi Hirata ◽  
Naoki Nakaya ◽  
Naho Tsuchiya ◽  
Tomohiro Nakamura ◽  
...  

Abstract Previous studies have reported a positive association between the urinary sodium-to-potassium (Na/K) ratio and hypertension, and multiple measurements of the casual urinary Na/K ratio are more strongly correlated with the 24-h urinary Na/K ratio than a single measurement. Multiple measurements of the urinary Na/K ratio might be more strongly associated with hypertension. We aimed to determine the association between multiple measurements of the casual urinary Na/K ratio and home hypertension compared with a single measurement. A population-based cross-sectional study was performed in Miyagi Prefecture, Japan. Subjects were over 20 years old and participated in the Tohoku Medical Megabank Project Cohort Study. We targeted 3273 subjects who borrowed home blood pressure (HBP) monitors and urinary Na/K ratio monitors for 10 consecutive days. The association between the urinary Na/K ratio and home hypertension (HBP ≥ 135/85 mmHg or under treatment for hypertension) was examined using multiple logistic regression models. To compare the prediction of home hypertension using multiple measurements with that using a single measurement, we calculated the area under the receiver operating characteristic curve (AUROC). Multiple measurements of the urinary Na/K ratio strongly related to home hypertension were better than 1 or 2 days of measurement (adjusted odds ratio of home hypertension per unit increase in urinary Na/K ratio over 6 days: 1.13–1.15). The AUROC of the urinary Na/K ratio measurement for home hypertension was stable after 5 days (AUROC = 0.779). In conclusion, multiple measurements of the urinary Na/K ratio are strongly related to home hypertension. This finding suggests that multiple measurements of the urinary Na/K ratio are useful for evaluating home hypertension.


2000 ◽  
Vol 39 (02) ◽  
pp. 200-203
Author(s):  
H. Mizuta ◽  
K. Yana

Abstract:This paper proposes a method for decomposing heart rate fluctuations into background, respiratory and blood pressure oriented fluctuations. A signal cancellation scheme using the adaptive RLS algorithm has been introduced for canceling respiration and blood pressure oriented changes in the heart rate fluctuations. The computer simulation confirmed the validity of the proposed method. Then, heart rate fluctuations, instantaneous lung volume and blood pressure changes are simultaneously recorded from eight normal subjects aged 20-24 years. It was shown that after signal decomposition, the power spectrum of the heart rate showed a consistent monotonic 1/fa type pattern. The proposed method enables a clear interpretation of heart rate spectrum removing uncertain large individual variations due to the respiration and blood pressure change.


1994 ◽  
Vol 72 (01) ◽  
pp. 058-064 ◽  
Author(s):  
Goya Wannamethee ◽  
A Gerald Shaper

SummaryThe relationship between haematocrit and cardiovascular risk factors, particularly blood pressure and blood lipids, has been examined in detail in a large prospective study of 7735 middle-aged men drawn from general practices in 24 British towns. The analyses are restricted to the 5494 men free of any evidence of ischaemic heart disease at screening.Smoking, body mass index, physical activity, alcohol intake and lung function (FEV1) were factors strongly associated with haematocrit levels independent of each other. Age showed a significant but small independent association with haematocrit. Non-manual workers had slightly higher haematocrit levels than manual workers; this difference increased considerably and became significant after adjustment for the other risk factors. Diabetics showed significantly lower levels of haematocrit than non-diabetics. In the univariate analysis, haematocrit was significantly associated with total serum protein (r = 0*18), cholesterol (r = 0.16), triglyceride (r = 0.15), diastolic blood pressure (r = 0.17) and heart rate (r = 0.14); all at p <0.0001. A weaker but significant association was seen with systolic blood pressure (r = 0.09, p <0.001). These relationships remained significant even after adjustment for age, smoking, body mass index, physical activity, alcohol intake, lung function, presence of diabetes, social class and for each of the other biological variables; the relationship with systolic blood pressure was considerably weakened. No association was seen with blood glucose and HDL-cholesterol. This study has shown significant associations between several lifestyle characteristics and the haematocrit and supports the findings of a significant relationship between the haematocrit and blood lipids and blood pressure. It emphasises the role of the haematocrit in assessing the risk of ischaemic heart disease and stroke in individuals, and the need to take haematocrit levels into account in determining the importance of other cardiovascular risk factors.


2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (&gt;140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.


JAMIA Open ◽  
2021 ◽  
Author(s):  
Beatrice Mugabirwe ◽  
Tabor Flickinger ◽  
Lauren Cox ◽  
Pius Ariho ◽  
Rebecca Dillingham ◽  
...  

Abstract Background Mobile technologies to improve blood pressure control in resource-limited settings are needed. We adapted and evaluated the acceptability and feasibility of PositiveLinks, a mobile phone application for self-monitoring, social support, and engagement in care for people living with HIV, among patients with hypertension in rural Uganda. Methods We enrolled adults on treatment for hypertension at Mbarara Regional Referral Hospital and Mbarara Municipal health center IV, southwestern Uganda. We provided and educated all participants on the use of PositiveLinks application and automated blood pressure monitors. We administered a baseline questionnaire and performed in-depth interviews 30 days later to explore acceptability, feasibility, medication adherence, social support, and blood pressure control. Results A total of 37 participants completed the interviews, mean age of 58 years (SD 10.8) and 28 (75.7%) were female. All participants embraced the PositiveLinks mobile app and were enthusiastic about self-monitoring of blood pressure, 35 (94.6%) experienced peer to peer support. Among the 35 participants non-adherent to medications at baseline, 31 had improved medication adherence. All except 1 of the 31(83.8%) who had uncontrolled blood pressure at baseline, had self-reported controlled blood pressure after 30 days of use of PositiveLinks. Conclusion Patients with hypertension in rural Uganda embraced the PositiveLinks mobile application and had improved medication adherence, social support, and blood pressure control. Further assessment of cost-effectiveness of the application in blood pressure control in resource-limited settings will be pursued in future studies.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e037874
Author(s):  
Lisa Hinton ◽  
James Hodgkinson ◽  
Katherine L Tucker ◽  
Linda Rozmovits ◽  
Lucy Chappell ◽  
...  

ObjectiveOne in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.DesignExploratory study using a qualitative approach.SettingEight hospitals, English National Health Service.ParticipantsObstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).MethodsSemi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.ResultsThe main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.ConclusionsThe potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women’s health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.Trial registration numberNCT03334149.


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