Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003–2017

Abstract

Few studies have reported association between sodium-to-potassium (Na-K) ratio and risk factors related to cardiovascular diseases (CVDs) among the general population in Asian countries. This study aimed to investigate the dietary sodium-to-potassium (Na-K) ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48,800 Japanese participants (19,386 men and 29,414 women) aged ≥20 years, registered in the 2003–2017 National Health and Nutrition Survey. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of hypertension, high glycated haemoglobin A1c (HbA1c) levels, hypercholesterolaemia, low serum levels of high-density lipoprotein (HDL) cholesterol, and high non-HDL cholesterol levels according to Na-K ratio, were estimated using logistic regression models. Dietary Na-K ratio decreased for both men and women from 2003 to 2017. Higher Na-K ratio and higher hypertension prevalence was observed (multivariate OR [fifth vs. first quintiles] = 1.27, 95% CI: 1.15, 1.40; P for trend <0.001 for men and 1.12, 95% CI: 1.01, 1.23; P for trend = 0.007 for women). Higher Na-K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR = 1.56, 95% CI: 1.24, 1.96). Prevalence of low HDL cholesterol levels was increased with higher Na-K ratio (P for trend = 0.002 for men and <0.001 for women). No significant associations were found between Na-K ratio and hypercholesterolaemia in men or high non-HDL cholesterol levels in both men and women. Our findings suggest that dietary Na-K ratio is associated with several CVD risk factors among Japanese adults.

Higher Potassium Intake and Lower Sodium Intake May Help in Reducing CVD Risk by Lowering Salt Sensitivity of Blood Pressure in the Han Chinese Population

“…Our results of a positive relationship between the 24hUNa/K and CVD risk have been suggested in other studies [ 32 , 33 , 34 ]. Nonetheless, dose–response relationships between Na and K intake and the Na/K with CVDs have not been fully explored [ 35 ] (Hooper LBartlett 2002).…”

“…One study conducted on Iranian participants suggested no relationship between dietary intakes of sodium and potassium and CVDs; however, participants with the highest compared to lowest tertile of Na/K ratio had an enhanced risk of CVDs [ 33 ]. Other studies showed that the dietary Na/K ratio was a significant risk factor for CVDs and all-cause mortality [ 32 ] and associated with several CVD risk factors among Japanese people [ 34 ]. Several studies indicated that a high dietary 24hUNa/K was a risk factor for diabetes, and associated with high insulin resistance [ 39 , 41 ].…”

Comparisons of Soybean and Wheat; in the Focus on the Nutritional Aspects and Acute Appetite Sensation

“…Moreover, soybean contains more minerals and vitamins than bread flour. It has been reported that the dietary Na/K ratio is associated with hypertension prevalence in Japanese individuals [34]. Furthermore, Mg intake is associated with the prevalence of prefrailty and frailty in older Japanese women [35].…”

The Relationship between Dietary Na/K Ratio and Bone Mineral Density in Korean Middle-Aged Women

“…Many studies have reported associations between the Na + /K + ratio and risk factors related to cardiovascular disease (CVD) in the general population. [20][21][22][23] A higher urinary Na + /K + ratio is also associated with an increased risk of subsequent CVD. 24) However, only a few studies have focused on the combined effects of sodium and potassium on bone health.…”

“…Many studies have reported associations between the Na + /K + ratio and risk factors related to cardiovascular disease (CVD) in the general population [ 20 - 23 ]. A higher urinary Na + /K + ratio is also associated with an increased risk of subsequent CVD [ 24 ].…”