Key result
An increase in the urinary sodium-to-potassium ratio over 4 years was positively associated with increased blood pressure, with the highest quintile of change increasing systolic blood pressure by 3.30 mmHg in women and 2.36 mmHg in men.
Why the study?
The study was conducted to assess the effect of changing the urinary sodium-to-potassium ratio on blood pressure at 4 years of follow-up.
Does a change in the urinary sodium-to-potassium ratio affect blood pressure in adults not taking antihypertensive medication?
Cohort (n=6,159)
Yes
Does a change in the urinary sodium-to-potassium ratio affect blood pressure in adults not taking antihypertensive medication?
Mean Difference: 3.3 (95% CI 2.18–4.41)
p-value: p=<0.001
An increase in the urinary sodium-to-potassium ratio over 4 years is associated with increased systolic and diastolic blood pressure in adults not on antihypertensive therapy.
Supports Na/K ratio monitoring in BP risk assessment; leaves open whether modifying it lowers BP in trials.
To assess the effect of changing the sodium to potassium (Na/K) ratio on blood pressure at 4 years of follow-up.The measurements were carried out under identical conditions in two study periods (2008-2010 and 2012-2014). Urinary excretion of sodium and potassium (mmol/L) over 12 nocturnal hours was used to calculate the Na/K ratio and categorized by quintile. The 24-hour sodium and potassium intake was estimated using a validated equation. The mean BP was calculated from 3 measurements after 5 minutes of rest. Of the 15,105 participants at baseline, 14,014 completed the first follow-up. Participants without validated urine collection (n = 5,041), using antihypertensive medication (n = 3,860) at either time points or reporting bariatric surgery during follow-up (n = 45) were excluded. The differences between follow-up and baseline values were calculated for BP and the Na/K ratio. Analyses were stratified by sex and adjusted for confounding variables.Sodium intake did not change from baseline, but potassium intake increased by approximately 150 mg in both sexes (P < .001), with a consequent reduction of the Na/K ratio. The highest quintile of change in the Na/K ratio was associated with greater variation in BP. When adjusted for covariates, it is possible to observe an increase in SBP in women from the third quintile of the Na/K ratio, in men this increase was observed from the fourth quintile. However, for DBP this increase is observed from the third quintile in both men and women.Increase in SBP was observed in women from the third quintile of the Na/K ratio, in men this increase is observed from the fourth quintile. However, for DBP this increase is observed from the third quintile in both men and women. The Na/K ratio demonstrated a greater association in BP.
No takes yet. Share an insight, caveat, or question.
Pereira et al. (2019) conducted a cohort in Blood pressure variation (n=6,159). Change in urinary sodium-to-potassium (Na/K) ratio vs. Lowest quintile of change in Na/K ratio was evaluated on Change in systolic blood pressure (SBP) for women in the highest vs lowest quintile of Na/K ratio change (MD 3.30, 95% CI 2.18-4.41, p=<0.001). An increase in the urinary sodium-to-potassium ratio over 4 years was positively associated with increased blood pressure, with the highest quintile of change increasing systolic blood pressure by 3.30 mmHg in women and 2.36 mmHg in men.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: