Key result
Multiple measurements of the urinary Na/K ratio over 5 or more days strongly predicted home hypertension, achieving a stable AUROC of 0.779.
Why the study?
Multiple measurements of casual urinary Na/K ratio correlate better with 24-h urinary Na/K ratio than a single measurement, but their comparative association with home hypertension was undetermined.
Do multiple measurements of the casual urinary Na/K ratio improve the prediction of home hypertension compared to a single measurement in community residents?
Cross-Sectional (n=3,273)
Yes
Do multiple measurements of the casual urinary Na/K ratio improve the prediction of home hypertension compared to a single measurement in community residents?
Effect estimate: AUROC 0.779 (95% CI 0.763-0.794)
p-value: p=<0.001
Multiple measurements of the casual urinary Na/K ratio over at least 5 days using a self-monitoring device provide a more reliable assessment of home hypertension risk than a single measurement.
May aid home hypertension prediction via repeated Na/K ratios; hypothesis-generating, needing prospective validation.
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.
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Kogure et al. (2019) conducted a cross-sectional in Home hypertension (n=3,273). Multiple measurements of urinary Na/K ratio vs. Single measurement (1 day) was evaluated on Prediction of home hypertension (HBP ≥ 135/85 mmHg or under treatment) (AUROC 0.779, 95% CI 0.763-0.794, p=<0.001). Multiple measurements of the urinary Na/K ratio over 5 or more days strongly predicted home hypertension, achieving a stable AUROC of 0.779.
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