Abstract
Recently, the sodium (Na)/potassium (K) ratio was reported to be associated with blood pressure (BP). A Na/K ratio self-monitoring device using spot urine was established recently. Here, we assessed whether the urinary Na/K ratio change measured using the Na/K device was associated with BP change in a health checkup setting. We targeted 12,890 participants who attended the health checkup in Tome City, Miyagi between 2017 and 2018. Tome City introduced urinary Na/K ratio measurements during health checkups since 2017. For each year, we compared the baseline characteristics according to the urinary Na/K ratio and BP level. We assessed the relationship between change in urinary Na/K ratio and BP change using multiple regression analyses adjusted for age, sex, and change in body mass index (BMI) and alcohol intake. The average urinary Na/K ratio was significantly lower in 2018 than in 2017 (5.4 ± 3.0 to 4.9 ± 2.2, P < 0.01). The systolic BP of the participants in 2018 (130.9 ± 17.4 mmHg) was lower than that in 2017 (132.1 ± 17.9 mmHg). Moreover, the change in systolic BP and diastolic BP was positively associated with the change in urinary Na/K ratio. In conclusion, the association of the change in urinary Na/K ratio with hypertension and changes in systolic and diastolic BP can be explained by a change in alcohol intake, BMI, and urinary Na/K ratio. Therefore, measuring the urinary Na/K ratio in community settings is a potential population approach for counteracting hypertension.
Highlights
Supplementary information The online version of this article contains supplementary material, which is available to authorized users.Recently, it was reported that the sodium (Na)/potassium (K) ratio was associated with blood pressure (BP) in a crosssectional analysis [1,2,3,4]
We assessed whether the urinary Na/K ratio change measured with the Na/K ratio measurement device was associated with BP change independent of confounding factors such as body mass index (BMI) change and change in alcohol intake and compared the BP level and urinary Na/K ratio at the community level
The change in urinary Na/K ratio was associated with the change in systolic BP (SBP) and diastolic BP (DBP)
Summary
It was reported that the sodium (Na)/potassium (K) ratio was associated with blood pressure (BP) in a crosssectional analysis [1,2,3,4] This is expected because high Na and K intake are known to be related to high and low BP, respectively [5,6,7]. Several equations for estimating Na intake or K intake using casual spot urine were recently established, these equations are not accurate enough to provide feedback to the individuals [10,11,12]. A Na/K ratio self-monitoring device using spot urine was established [13] It did not assess the actual Na intake level, it can provide feedback regarding the urinary Na/K balance in a few minutes. We assessed whether the urinary Na/K ratio change measured with the Na/K ratio measurement device was associated with BP change independent of confounding factors such as body mass index (BMI) change and change in alcohol intake and compared the BP level and urinary Na/K ratio at the community level
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