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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Association of urinary sodium and potassium excretion with blood pressure
New England Journal of Medicine, Volume 371, No. 7, Year 2014
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Description
BACKGROUND: Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown. METHODS: We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device. RESULTS: Regression analyses showed increments of 2.11 mm Hg in systolic blood pressure and 0.78 mm Hg in diastolic blood pressure for each 1-g increment in estimated sodium excretion. The slope of this association was steeper with higher sodium intake (an increment of 2.58 mm Hg in systolic blood pressure per gram for sodium excretion >5 g per day, 1.74 mm Hg per gram for 3 to 5 g per day, and 0.74 mm Hg per gram for <3 g per day; P<0.001 for interaction). The slope of association was steeper for persons with hypertension (2.49 mm Hg per gram) than for those without hypertension (1.30 mm Hg per gram, P<0.001 for interaction) and was steeper with increased age (2.97 mm Hg per gram at >55 years of age, 2.43 mm Hg per gram at 45 to 55 years of age, and 1.96 mm Hg per gram at <45 years of age; P<0.001 for interaction). Potassium excretion was inversely associated with systolic blood pressure, with a steeper slope of association for persons with hypertension than for those without it (P<0.001) and a steeper slope with increased age (P<0.001). CONCLUSIONS: In this study, the association of estimated intake of sodium and potassium, as determined from measurements of excretion of these cations, with blood pressure was nonlinear and was most pronounced in persons consuming high-sodium diets, persons with hypertension, and older persons. Copyright © 2014 Massachusetts Medical Society.
Authors & Co-Authors
Mente, Andrew
Unknown Affiliation
O'Donnell, Martin J.
Unknown Affiliation
Rangarajan, Sumathy
Unknown Affiliation
McQueen, Matthew J.
Unknown Affiliation
Poirier, Paul P.
Unknown Affiliation
Wielgosz, Andreas T.J.
Unknown Affiliation
Morrison, Howard
Unknown Affiliation
Li, Wei
Unknown Affiliation
Wang, Xingyu
Unknown Affiliation
Di, Chen
Unknown Affiliation
Mony, Prem Kumar
Unknown Affiliation
Devanath, Anitha
Unknown Affiliation
Rosengren, Annika H.
Unknown Affiliation
Oǧuz, Aytekin
Unknown Affiliation
Zatońska, Katarzyna
Unknown Affiliation
Yusufali, Afzal Hussein
Unknown Affiliation
López-Jaramillo, P.
Unknown Affiliation
Avezum, Álvaro Jr
Unknown Affiliation
Ismail, Noor Hassim
Unknown Affiliation
Lanas, Fernando T.
Unknown Affiliation
Puoane, Thandi Rose
Unknown Affiliation
Díaz, Rafaël J.
Unknown Affiliation
Kelishadi, Roya
Unknown Affiliation
Iqbal, Romaina
Unknown Affiliation
Yusuf, Rita
Unknown Affiliation
Chifamba, Jephat
Unknown Affiliation
Khatib, Rasha
Unknown Affiliation
Teo, Koonkang
Unknown Affiliation
Yusuf, Salim N.
Unknown Affiliation
Statistics
Citations: 705
Authors: 29
Affiliations: 26
Identifiers
Doi:
10.1056/NEJMoa1311989
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Noncommunicable Diseases