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CN 34-1304/RISSN 1674-3679

Volume 28 Issue 8
Aug.  2024
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GUO Rui, ZHANG Bingyin, XU Chunxiao, DONG Jing, REN Jie, LIU Danru, LU Zilong, GUO Xiaolei. Association between urinary sodium and potassium excretion and blood pressure among adults in Shandong Province, China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 929-936. doi: 10.16462/j.cnki.zhjbkz.2024.08.010
Citation: GUO Rui, ZHANG Bingyin, XU Chunxiao, DONG Jing, REN Jie, LIU Danru, LU Zilong, GUO Xiaolei. Association between urinary sodium and potassium excretion and blood pressure among adults in Shandong Province, China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 929-936. doi: 10.16462/j.cnki.zhjbkz.2024.08.010

Association between urinary sodium and potassium excretion and blood pressure among adults in Shandong Province, China

doi: 10.16462/j.cnki.zhjbkz.2024.08.010
Funds:  Fund program: Joint Three Reduction and Three High Control Project of the National Health Commission and Shandong Provincial People′s Government (2019)
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  • Corresponding author: GUO Xiaolei, E-mail: guoxiaolei@126.com
  • Received Date: 2024-02-29
  • Rev Recd Date: 2024-05-17
  • Available Online: 2024-09-29
  • Publish Date: 2024-08-10
  •   Objective  To analyze the association between urinary sodium and potassium excretion with the risk of hypertension and blood pressure levels among adults in Shandong Province, China.  Methods  Residents aged 18-69 years were selected for questionnaire survey, physical examination, and random spot urine collection in Shandong Province in 2019. The 24 hour urinary sodium and potassium excretion was estimated by spot urine through the Tanaka formula. Dose-response relationship and association of 24 hour urinary sodium and potassium excretion with the risk of hypertension and blood pressure levels using restricted cubic spline, logistic regression models, and linear regression models. Subgroup analyses were conducted according to different ages, genders, and antihypertensive drug usage.  Results  A total of 3 280 subjects were included, 24 hour urinary sodium, urinary potassium and urinary sodium-potassium ratios were (4.12±0.95) g/d, (1.70±0.39) g/d and (2.51±0.69). For every 1g/d increase in sodium excretion, systolic blood pressure increases by 1.221 mmHg (95% CI: 0.611-1.830, P < 0.001), and diastolic blood pressure increases by 0.612 mmHg (95% CI: 0.201-1.023, P=0.004). For every 1g/d increase in potassium excretion, systolic blood pressure decreases by 2.297 mmHg (95% CI: -3.797--0.796, P=0.003) and diastolic blood pressure decreases by 1.159 mmHg (95% CI: -2.171--0.147, P=0.025). Compared with the group with a urinary sodium-potassium ratio of < 2.0, the ≥2.9 group increases the risk of hypertension by 37% (95% CI: 1.062-1.769, P=0.015), with an increase in systolic blood pressure of 3.047 mmHg (95% CI: 1.470-4.624, P < 0.001) and diastolic blood pressure of 1.796 mmHg (95% CI: 0.734-2.859, P=0.001). There was no interaction for any of the metrics except for a multiplicative interaction for gender and urinary potassium in the association with systolic blood pressure (P=0.015).  Conclusions  With the increase of urinary sodium and the decrease of urinary potassium, the risk of hypertension, systolic blood pressure and diastolic blood pressure all increase, and the use of random spot urine for assessing the risk of hypertension in large epidemiological surveys is scientifically valid.
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