Abstract
High dietary sodium and low potassium intake increase blood pressure and risk of hypertension, but whether the relationship between dietary sodium and potassium and risk of hypertension is different in North China and South China remains unclear. We used data from the longitudinal China Health and Nutrition Survey (CHNS) and selected 6705 adults who participated in at least two waves in 2009, 2011, and 2015 and had no hypertension in baseline. We performed multiple linear regression analysis and multiple logistic regressions stratified by area for the present study design. Sodium and potassium intake were higher in North China (4343.4 and 1624.8 mg/day, respectively) than in South China (4107.8 and 1516.1 mg/d, respectively) (p < 0.05). Multiple linear regression revealed that a positive correlation of sodium intake (β = 0.026, p < 0.05) and ratio of sodium to potassium (Na-K) intake (β = 0.041, p < 0.01) with diastolic blood pressure (DBP) was found in North China, and the association of sodium, potassium, and Na-K intake ratio with blood pressure was different in South China. Multiple logistic regressions documented a similar significant inverse association between dietary potassium intake and risk of hypertension in both North China and South China (risk ratio (RR): 0.63, 95%CI: 0.50–0.79; RR: 0.80, 95%CI: 0.66–0.98, respectively). The risk of hypertension increased in the fourth quartile of dietary sodium and Na-K intake ratio (RR: 1.20, 95%CI: 1.00–1.44; RR: 1.35, 95%CI: 1.13–1.62, respectively) in North China but no association was observed in South China. The current study indicates a different association of dietary sodium and Na-K intake ratio with systolic blood pressure (SBP), DBP, and risk of hypertension in North China and South China.
Highlights
Hypertension is the leading preventable risk factor for premature death and disability worldwide [1]
In 2017, it was the number one risk factor contributing to deaths and disability adjusted life years (DALYs) in China, accounting for 2.54 million deaths of which 95.7% were due to cardiovascular diseases [4]
There was a different association of dietary sodium and Na-K intake ratio with diastolic blood pressure (DBP) and hypertension between South China and North China
Summary
Hypertension is the leading preventable risk factor for premature death and disability worldwide [1]. In 2010, 31.1% of the global adult population, or about 1.34 billion to 1.44 billion, had hypertension [2]. 23.2% (estimated 244.5 million) of Chinese adults had hypertension [3]. In 2017, it was the number one risk factor contributing to deaths and disability adjusted life years (DALYs) in China, accounting for 2.54 million deaths of which 95.7% were due to cardiovascular diseases [4]. The World Health Organization (WHO) and other organizations have emphasized the relationship of dietary sodium, potassium, and sodium to potassium ratio with hypertension and cardiovascular disease [5,6,7]. Based on the findings from the China National Health and Nutrition
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