Differential associations of dietary sodium and potassium intake with blood pressure: a focus on pulse pressure

High dietary sodium and low potassium intake increase blood pressure and risk of hypertension, but whether the relationship between dietary sodium and potassium and risk of hypertension is different in North China and South China remains unclear. We used data from the longitudinal China Health and Nutrition Survey (CHNS) and selected 6705 adults who participated in at least two waves in 2009, 2011, and 2015 and had no hypertension in baseline. We performed multiple linear regression analysis and multiple logistic regressions stratified by area for the present study design. Sodium and potassium intake were higher in North China (4343.4 and 1624.8 mg/day, respectively) than in South China (4107.8 and 1516.1 mg/d, respectively) (p < 0.05). Multiple linear regression revealed that a positive correlation of sodium intake (β = 0.026, p < 0.05) and ratio of sodium to potassium (Na-K) intake (β = 0.041, p < 0.01) with diastolic blood pressure (DBP) was found in North China, and the association of sodium, potassium, and Na-K intake ratio with blood pressure was different in South China. Multiple logistic regressions documented a similar significant inverse association between dietary potassium intake and risk of hypertension in both North China and South China (risk ratio (RR): 0.63, 95%CI: 0.50–0.79; RR: 0.80, 95%CI: 0.66–0.98, respectively). The risk of hypertension increased in the fourth quartile of dietary sodium and Na-K intake ratio (RR: 1.20, 95%CI: 1.00–1.44; RR: 1.35, 95%CI: 1.13–1.62, respectively) in North China but no association was observed in South China. The current study indicates a different association of dietary sodium and Na-K intake ratio with systolic blood pressure (SBP), DBP, and risk of hypertension in North China and South China.

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Dietary Sodium and Potassium Intake Is Not Associated With Elevated Blood Pressure in US Adults With No Prior History of Hypertension

Journal of Clinical Hypertension ◽

10.1111/jch.12312 ◽

2014 ◽

Vol 16 (6) ◽

pp. 418-423 ◽

Cited By ~ 9

Author(s):

Shailendra Sharma ◽

Kim McFann ◽

Michel Chonchol ◽

Jessica Kendrick

Keyword(s):

Blood Pressure ◽

Elevated Blood Pressure ◽

Dietary Sodium ◽

Prior History ◽

Elevated Blood ◽

Potassium Intake ◽

History Of ◽

Sodium And Potassium

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

Scientific Reports ◽

10.1038/s41598-021-83049-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xiaofu Du ◽

Le Fang ◽

Jianwei Xu ◽

Xiangyu Chen ◽

Yamin Bai ◽

...

Keyword(s):

Blood Pressure ◽

Sodium Excretion ◽

Sodium Intake ◽

Urinary Sodium Excretion ◽

Urinary Sodium ◽

Inverse Association ◽

Potassium Excretion ◽

Chinese Adults ◽

Potassium Intake ◽

Sodium And Potassium

AbstractThe 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.

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Daily dietary sodium and potassium intake in Belgium, using duplicate portion sampling

European Food Research and Technology ◽

10.1007/s002170050458 ◽

1999 ◽

Vol 209 (1) ◽

pp. 63-67 ◽

Cited By ~ 7

Author(s):

Rudy Van Cauwenbergh ◽

Peter Hendrix ◽

H. J. Robberecht ◽

Hendrik A. Deelstra

Keyword(s):

Dietary Sodium ◽

Potassium Intake ◽

Duplicate Portion Sampling ◽

Duplicate Portion ◽

Sodium And Potassium

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Abstract P184: Effects of Sodium and Potassium Supplementation on Blood Pressure and Arterial Stiffness in Untreated (Pre)Hypertensives on a Low-Sodium, Low-Potassium Diet

Circulation ◽

10.1161/circ.129.suppl_1.p184 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Lieke Gijsbers ◽

James Dower ◽

Marco Mensink ◽

Johanna M Geleijnse

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Random Order ◽

Potassium Intake ◽

Low Sodium ◽

Potassium Supplementation ◽

Urinary Potassium ◽

Low Potassium ◽

Sodium And Potassium ◽

Sodium Supplementation

Introduction: We performed a 12-week randomized placebo-controlled crossover study to examine the effects of sodium and potassium supplementation on blood pressure (BP) and arterial stiffness in untreated (pre)hypertensive individuals on a low-sodium, low-potassium diet. Methods: During the study, subjects were on a fully controlled diet that provided on average 2.4 g/d of sodium (equals 6 g/d of salt) and 2.2 g/d of potassium. After a 1-week run-in period, 37 subjects received capsules with supplemental sodium (3 g/d, equals 7.5 g/d of salt), supplemental potassium (3 g/d), or placebo, for four weeks each (not separated by wash-out), in random order. Fasting office BP, 24-h ambulatory BP, and measures of arterial stiffness (SphygmoCor®) were assessed at baseline and after each treatment. Results: Subjects had a mean pre-treatment BP of 145/81 mmHg and 68% (25 of 37) had systolic BP (SBP) ≥140 mmHg. In 36 subjects who completed the study, sodium supplementation increased urinary sodium by 97.6 mmol/24h (2.2 g/d) and potassium supplementation increased urinary potassium by 62.9 mmol/24h (2.5 g/d), compared to placebo (Table). Sodium supplementation significantly increased office BP by 7.5/3.3 mmHg, 24-h BP by 7.0/2.1 mmHg and central BP by 8.5/3.6 mmHg. Potassium supplementation significantly reduced 24-h BP by 4.0/1.7 mmHg. Measures of arterial stiffness did not change. Conclusion: Increasing the intake of sodium has a strong adverse effect on BP in untreated (pre)hypertensive individuals. Increased potassium intake, however, lowers BP even when people are on a reduced sodium diet. Short-term changes in sodium and potassium intake have little effect on arterial stiffness. Trial registration: ClinicalTrials.gov Identifier: NCT01575041

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