Abstract
Objectives
To estimate the longitudinal association between self-reported doctor diagnosis of hypertension and subsequent short-term changes (within 2–4 years) in sodium intake, potassium intake and sodium-potassium (Na/K) ratio.
Methods
We used data from nine waves of the China Health and Nutrition Survey (1991 to 2015) including 16,268 adults (18–75 years of age) without hypertension at their first entry wave. Diet data were collected using three consecutive 24-hour dietary recalls and a weighed household food inventory. Diagnosed hypertension was defined as self-reported doctor diagnosis of hypertension. We used fixed-effects models to estimate the association between the first occurrence of a hypertension diagnosis and subsequent within-individual changes in sodium intake, potassium intake and Na/K ratio. To further understand the observed heterogeneity by sex, we examined changes in diet outcomes in pairs of spouses, and changes at the household level.
Results
Model-based results suggest that on average, men who were diagnosed with hypertension decreased their sodium intake by 260 mg/d and their Na/K ratio by 0.21 within two to four years after diagnosis (P < 0.01). Among spouse pairs, sodium intake and Na/K ratio of women decreased when their husbands were diagnosed with hypertension (P < 0.05). At the household level, sodium density and Na/K ratio decreased (-8.5 mg/100 kcal and -0.19) after a man was diagnosed (P < 0.05). In contrast, when women were diagnosed, sodium, potassium and Na/K ratio changes associated with hypertension diagnosis were not statistically significant.
Conclusions
Our study suggests that when men were diagnosed with hypertension, dietary sodium intake and Na/K ratio improved for them, as well as their wife and other household members. However, when women were diagnosed, none of the changes were statistically significant. There is a need to address the gender bias, along with efforts to increase hypertension diagnosis in China.
Funding Sources
The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Heart, Lung, Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and CONACyT.
Is a Hypertension Diagnosis Associated With Improved Dietary Outcomes Within 2 to 4 Years? A Fixed‐Effects Analysis From the China Health and Nutrition Survey