Details:

Alternative Title:
Circulation
Publisher's site:
http://dx.doi.org/10.1161/CIRCULATIONAHA.117.029193
Personal Author:
Jackson, Sandra L. ; Cogswell, Mary E. ; Zhao, Lixia ; Terry, Ana L. ; Wang, Chia-Yih ; ... More +
Jackson, Sandra L. ; Cogswell, Mary E. ; Zhao, Lixia ; Terry, Ana L. ; Wang, Chia-Yih ; Wright, Jacqueline ; Coleman King, Sallyann M. ; Bowman, Barbara ; Chen, Te-Ching ; Merritt, Robert ; Loria, Catherine M. Less -
Description:
Background

Higher levels of sodium and lower levels of potassium intake are associated with higher blood pressure. However, the shape and magnitude of these associations can vary by study participant characteristics or intake assessment method. Twenty-four hour urinary excretion of sodium and potassium are unaffected by recall errors and represent all sources of intake, and were collected for the first time in a nationally representative US survey. Our objective was to assess the associations of blood pressure and hypertension with 24-hour urinary excretion of sodium and potassium among US adults.

Methods

Cross-sectional data from 766 participants aged 20–69 years with complete blood pressure and 24-hour urine collections in the 2014 National Health and Nutrition Examination Survey, a nationally-representative survey of the US noninstitutionalized population. Usual 24-hour urinary electrolyte excretion (sodium, potassium, and their ratio) was estimated from up to two collections on non-consecutive days, adjusting for day-to-day variability in excretion. Outcomes included systolic and diastolic blood pressure from the average of 3 measures and hypertension status, based on average blood pressure ≥140/90 and anti-hypertensive medication use.

Results

After multivariable adjustment, each 1000 mg difference in usual 24-hour sodium excretion was directly associated with systolic (4.58 mmHg, 95% confidence interval 2.64,6.51) and diastolic (2.25 mmHg, 95% CI 0.83,3.67) blood pressures. Each 1000 mg difference in potassium excretion was inversely associated with systolic blood pressure (−3.72 mmHg, 95% CI −6.01, −1.42). Each 0.5 unit difference in sodium-to-potassium ratio was directly associated with systolic blood pressure (1.72 mmHg, 95% CI 0.76, 2.68). Hypertension was linearly associated with progressively higher sodium and lower potassium excretion; compared with the lowest quartiles of excretion, the adjusted odds of hypertension for the highest quartiles were 4.22 (95% CI 1.36, 13.15) for sodium, and 0.38 (95% CI 0.17, 0.87) for potassium, respectively, P<0.01 for trends.

Conclusions

These cross-sectional results show a strong dose-response association between urinary sodium excretion and blood pressure, and an inverse association between urinary potassium excretion and blood pressure, in a nationally representative sample of US adults.


Subjects:
[+]
Article Blood Pressure Hypertension Potassium Sodium
Source:
Circulation. 137(3):237-246
Pubmed ID:
29021321
Pubmed Central ID:
PMC5771856
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:eb02395e119fdc7ffb747a769115c29953d0eff14d62fcf23f8cd7ebdb85101d
Download URL:
https://stacks.cdc.gov/view/cdc/51031/cdc_51031_DS1.pdf
File Type:

Supporting Files

• 	NIHMS916449-supplement-Supplemental_PDF.pdf	pdf
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