Associations of Dietary Sodium, Potassium, and Sodium to Potassium Ratio with Blood Pressure—Regional Disparities in China

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.

Dietary Sodium and Potassium Intake: Data from the Mexican National Health and Nutrition Survey 2016

“…Another study carried out with American adults showed that the mean population consumption was close to 3 500 mg/day, while the mean K consumption was close to 2 800 mg/day [65]. Our results did not show a high proportion between Na: K; however, other countries have shown that these proportions are above two [63,64], which was related to diastolic and systolic pressure. Mexican adults have shown to have the highest potassium consumption in the population.…”

“…This study showed that the estimated Na intake was high (2 600 mg/day), while the (urinary) K intake was low (1 982 mg/day) [10]. A study carried out in China showed that Na consumption in the adult population was above 4 100 mg/day, while K consumption was between 1 500 and 1 600 mg / day [63]. A study carried out with Australian adults showed that the median K intake was high, since it was above 3 000 mg/day [64].…”

Trends in Prevalence of Hypertension and Hypertension Phenotypes Among Chinese Children and Adolescents Over Two Decades (1991–2015)

“…Similarly, children living in South China were less likely to be affected by hypertension, stage 1 hypertension and IDH. It has been estimated that diary sodium intake in North China is higher than that in South China, which might have attributed to the differences across geographic regions ( 45 ).…”

Survey on sodium and potassium intake in patients with hypertension in China

“…A recent study in a general Chinese population, which used 24 h-recall as measurement of diet electrolytes, showed similar findings for regional differences between north and south China. 16 The focus of this study: a large-scale epidemiological survey involving 130 hospitals in 23 provinces of China was conducted to examine the salt intake status of Chinese hypertensive patients. Our study also assessed salt intake levels of hypertensive patients of different ages.…”

“…A recent study in a general Chinese population, which used 24 h‐recall as measurement of diet electrolytes, showed similar findings for regional differences between north and south China. 16 …”