Abstract
Many public health policies in Latin America target an optimized sodium and potassium intake. The aims of this study were to assess the sodium and potassium intake using 24-hour urinary analysis and to study their association with blood pressure in a Uruguayan population cohort using cluster analysis. A total of 149 participants (aged 20–85 years) were included in the study, and office blood pressure, anthropometric measurements, biochemical parameters in the blood, and 24-hour urine samples were obtained. The overall mean sodium and potassium excretion was 152.9 ± 57.3 mmol/day (8.9 ± 3.4 g/day of salt) and 55.4 ± 19.6 mmol/day, respectively. The average office systolic/diastolic blood pressure was 124.6 ± 16.7/79.3 ± 9.9 mmHg. Three compact spherical clusters were defined in untreated participants based on predetermined attributes, including blood pressure, age, and sodium and potassium excretion. The major characteristics of the three clusters were (1) high systolic blood pressure and moderate sodium excretion, (2) moderate systolic blood pressure and very high sodium excretion, and (3) low systolic blood pressure and low sodium excretion. Participants in cluster three had systolic blood pressure values that were 23.9 mmHg (95% confidence interval: −29.5 to −1.84) lower than those in cluster one. Participants in cluster two had blood pressure levels similar to those in cluster one (P = 0.32) and worse metabolic profiles than those in cluster one and three (P < 0.05). None of the clusters showed high blood pressure levels and high sodium excretion. No linear association was found between blood pressure and urinary sodium excretion (r < 0.14; P > 0.47). An effect of sodium and potassium intake on blood pressure levels was not found at the population level using regression or cluster analysis.
Highlights
Cardiovascular disease is a major health problem that is strongly related to population growth and aging
High blood pressure (BP) remains the leading global risk factor for cardiovascular disease, and the highest BP levels have shifted from high-income to low-income countries during the past four decades [1]
A high proportion of participants (98.3% of men and 84.3% of women) showed sodium intake that was over the current recommendations as assessed through 24-hour urinary sodium excretion values [15]
Summary
Cardiovascular disease is a major health problem that is strongly related to population growth and aging. High blood pressure (BP) remains the leading global risk factor for cardiovascular disease, and the highest BP levels have shifted from high-income to low-income countries during the past four decades [1]. In southern Latin America, the prevalence of hypertension is high [2]. Analysis of the effect of dietary sodium on BP and cardiovascular events has shown inconsistent results [3,4,5], and the optimal sodium intake for cardiovascular health remains under debate [6]. The average global sodium intake among adults has remained stable over the years at ∼4000 mg/day (∼10 g/day of salt) [7]
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