Document Detail


Association of urinary sodium and potassium excretion with blood pressure.
MedLine Citation:
PMID:  25119606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown.
METHODS: We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device.
RESULTS: Regression analyses showed increments of 2.11 mm Hg in systolic blood pressure and 0.78 mm Hg in diastolic blood pressure for each 1-g increment in estimated sodium excretion. The slope of this association was steeper with higher sodium intake (an increment of 2.58 mm Hg in systolic blood pressure per gram for sodium excretion >5 g per day, 1.74 mm Hg per gram for 3 to 5 g per day, and 0.74 mm Hg per gram for <3 g per day; P<0.001 for interaction). The slope of association was steeper for persons with hypertension (2.49 mm Hg per gram) than for those without hypertension (1.30 mm Hg per gram, P<0.001 for interaction) and was steeper with increased age (2.97 mm Hg per gram at >55 years of age, 2.43 mm Hg per gram at 45 to 55 years of age, and 1.96 mm Hg per gram at <45 years of age; P<0.001 for interaction). Potassium excretion was inversely associated with systolic blood pressure, with a steeper slope of association for persons with hypertension than for those without it (P<0.001) and a steeper slope with increased age (P<0.001).
CONCLUSIONS: In this study, the association of estimated intake of sodium and potassium, as determined from measurements of excretion of these cations, with blood pressure was nonlinear and was most pronounced in persons consuming high-sodium diets, persons with hypertension, and older persons. (Funded by the Heart and Stroke Foundation of Ontario and others.).
Authors:
Andrew Mente; Martin J O'Donnell; Sumathy Rangarajan; Matthew J McQueen; Paul Poirier; Andreas Wielgosz; Howard Morrison; Wei Li; Xingyu Wang; Chen Di; Prem Mony; Anitha Devanath; Annika Rosengren; Aytekin Oguz; Katarzyna Zatonska; Afzal Hussein Yusufali; Patricio Lopez-Jaramillo; Alvaro Avezum; Noorhassim Ismail; Fernando Lanas; Thandi Puoane; Rafael Diaz; Roya Kelishadi; Romaina Iqbal; Rita Yusuf; Jephat Chifamba; Rasha Khatib; Koon Teo; Salim Yusuf;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  371     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-08-14     Completed Date:  2014-08-19     Revised Date:  2014-11-05    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  601-11     Citation Subset:  AIM; IM    
Export Citation:
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Blood Pressure / physiology*
Diet*
Female
Humans
Hypertension / physiopathology,  urine
Linear Models
Male
Middle Aged
Potassium / administration & dosage,  urine*
Sensitivity and Specificity
Sodium / urine*
Sodium, Dietary / administration & dosage
Chemical
Reg. No./Substance:
0/Sodium, Dietary; 9NEZ333N27/Sodium; RWP5GA015D/Potassium
Investigator
Investigator/Affiliation:
S Yusuf / ; S Rangarajan / ; K K Teo / ; C K Chow / ; M O'Donnell / ; A Mente / ; D Leong / ; A Smyth / ; P Joseph / ; S Islam / ; M Zhang / ; W Hu / ; G Wong / ; ShunFu Lee / ; N Manandhar / ; M Dehghan / ; M Royerr / ; J DeJesus / ; G Lewis / ; P Mackie / ; L Farago / ; I Kay / ; D Agapay / ; R Solano / ; S Ramacham / ; N Kandy / ; J Rimac / ; S Trottier / ; W ElSheikh / ; M Mustaha / ; T Tongana / ; N Aoucheva / ; J Swallow / ; E Ramezani / ; J Lindeman / ; M McQueen / ; K Hall / ; J Keys / ; X Wang / ; J Keneth / ; A Devanath / ; R Diaz / ; A Orlandini / ; B Linetsky / ; S Toscanelli / ; G Casaccia / ; J M Maini Cuneo / ; O Rahman / ; R Yusuf / ; A K Azad / ; K A Rabbani / ; H M Cherry / ; A Mannan / ; I Hassan / ; A T Talukdar / ; R B Tooheen / ; M U Khan / ; M Sintaha / ; T Choudhury / ; R Haque / ; S Parvin / ; A Avezum / ; G B Oliveira / ; C S Marcilio / ; A C Mattos / ; K Teo / ; S Yusuf / ; J Dejesus / ; D Agapay / ; T Tongana / ; R Solano / ; I Kay / ; S Trottier / ; J Rimac / ; W Elsheikh / ; L Heldman / ; E Ramezani / ; G Dagenais / ; P Poirier / ; G Turbide / ; D Auger / ; A LeBlanc / ; A LeBlanc De Bluts / ; M C Proulx / ; M Cayer / ; N Bonneville / ; S Lear / ; D Gasevic / ; E Corber / ; V de Jong / ; I Vukmirovich / ; A Wielgosz / ; G Fodor / ; A Pipe / ; A Shane / ; F Lanas / ; P Seron / ; S Martinez / ; A Valdebenito / ; M Oliveros / ; Li Wei / ; Liu Lisheng / ; Chen Chunming / ; Wang Xingyu / ; Zhao Wenhua / ; Zhang Hongye / ; Jia Xuan / ; Hu Bo / ; Sun Yi / ; Bo Jian / ; Zhao Xiuwen / ; Chang Xiaohong / ; Chen Tao / ; Chen Hui / ; Chang Xiaohong / ; Deng Qing / ; Cheng Xiaoru / ; Deng Qing / ; He Xinye / ; Hu Bo / ; Jia Xuan / ; Li Jian / ; Li Juan / ; Liu Xu / ; Ren Bing / ; Sun Yi / ; Wang Wei / ; Wang Yang / ; Yang Jun / ; Zhai Yi / ; Zhang Hongye / ; Zhao Xiuwen / ; Zhu Manlu / ; Lu Fanghong / ; Wu Jianfang / ; Li Yindong / ; Hou Yan / ; Zhang Liangqing / ; Guo Baoxia / ; Liao Xiaoyang / ; Zhang Shiying / ; Bian Rongwen / ; Tian Xiuzhen / ; Li Dong / ; Chen Di / ; Wu Jianguo / ; Xiao Yize / ; Liu Tianlu / ; Zhang Peng / ; Dong Changlin / ; Li Ning / ; Ma Xiaolan / ; Yang Yuqing / ; Lei Rensheng / ; Fu Minfan / ; He Jing / ; Liu Yu / ; Xing Xiaojie / ; Zhou Qiang / ; P Lopez-Jaramillo / ; P A Camacho Lopez / ; R Garcia / ; L J A Jurado / ; D Gómez-Arbelaez / ; J F Arguello / ; R Duenas / ; S Silva / ; L P Pradilla / ; F Ramirez / ; D I Molina / ; C Cure-Cure / ; M Perez / ; E Hernandez / ; E Arcos / ; S Fernandez / ; C Narvaez / ; J Paez / ; A Sotomayor / ; H Garcia / ; G Sanchez / ; T David / ; A Rico / ; P Mony / ; M Vaz / ; A V Bharathi / ; S Swaminathan / ; K Shankar / ; A V Kurpad / ; K G Jayachitra / ; N Kumar / ; V Mohan / ; M Deepa / ; K Parthiban / ; M Anitha / ; S Hemavathy / ; T Rahulashankiruthiyayan / ; D Anitha / ; K Sridevi / ; R Gupta / ; R B Panwar / ; I Mohan / ; P Rastogi / ; S Rastogi / ; R Bhargava / ; R Kumar / ; J S Thakur / ; B Patro / ; P V M Lakshmi / ; R Mahajan / ; P Chaudary / ; V Raman Kutty / ; K Vijayakumar / ; K Ajayan / ; G Rajasree / ; A R Renjini / ; A Deepu / ; B Sandhya / ; S Asha / ; H S Soumya / ; R Kelishadi / ; A Bahonar / ; N Mohammadifard / ; H Heidari / ; K Yusoff / ; T S T Ismail / ; K K Ng / ; A Devi / ; N M Nasir / ; M M Yasin / ; M Miskan / ; E A Rahman / ; M K M Arsad / ; F Ariffin / ; S A Razak / ; F A Majid / ; N A Bakar / ; M Y Yacob / ; N Zainon / ; R Salleh / ; M K A Ramli / ; N A Halim / ; S R Norlizan / ; N M Ghazali / ; M N Arshad / ; R Razali / ; S Ali / ; H R Othman / ; C W J C W Hafar / ; A Pit / ; N Danuri / ; F Basir / ; S N A Zahari / ; H Abdullah / ; M A Arippin / ; N A Zakaria / ; I Noorhassim / ; M J Hasni / ; M T Azmi / ; M I Zaleha / ; K Y Hazdi / ; A R Rizam / ; W Sazman / ; A Azman / ; R Khatib / ; U Khammash / ; A Khatib / ; R Giacaman / ; A Husseini / ; R Iqbal / ; A Afridi / ; R Khawaja / ; A Raza / ; K Kazmi / ; W Zatonski / ; A Szuba / ; K Zatonska / ; R Ilow / ; M Ferus / ; B Regulska-Ilow / ; D Rózańska / ; M Wolyniec / ; A Kruger / ; H H Voster / ; A E Schutte / ; E Wentzel-Viljoen / ; F C Eloff / ; H de Ridder / ; H Moss / ; J Potgieter / ; A A Roux / ; M Watson / ; G de Wet / ; A Olckers / ; J C Jerling / ; M Pieters / ; T Hoekstra / ; T Puoane / ; E Igumbor / ; L Tsolekile / ; D Sanders / ; P Naidoo / ; N Steyn / ; N Peer / ; B Mayosi / ; B Rayner / ; V Lambert / ; N Levitt / ; T Kolbe-Alexander / ; L Ntyintyane / ; G Hughes / ; R Swart / ; J Fourie / ; M Muzigaba / ; S Xapa / ; N Gobile / ; K Ndayi / ; B Jwili / ; K Ndibaza / ; B Egbujie / ; A Rosengren / ; K Bengtsson Bostrom / ; U Lindblad / ; P Langkilde / ; A Gustavsson / ; M Andreasson / ; M Snallman / ; L Wirdemann / ; K Pettersson / ; E Moberg / ; A Oguz / ; A A K Akalin / ; K B T Calik / ; N Imeryuz / ; A Temizhan / ; E Alphan / ; E Gunes / ; H Sur / ; K Karsidag / ; S Gulec / ; Y Altuntas / ; A M Yusufali / ; W Almahmeed / ; H Swidan / ; E A Darwish / ; A R A Hashemi / ; N Al-Khaja / ; J M Muscat-Baron / ; S H Ahmed / ; T M Mamdouh / ; W M Darwish / ; M H S Abdelmotagali / ; S A Omer Awed / ; G A Movahedi / ; F Hussain / ; H Al Shaibani / ; R I M Gharabou / ; D F Youssef / ; A Z S Nawati / ; Z A R Abu Salah / ; R F E Abdalla / ; S M Al Shuwaihi / ; M A Al Omairi / ; O D Cadigal / ; R S Alejandrino / ; J Chifamba / ; L Gwaunza / ; G Terera / ; C Mahachi / ; P Mrambiwa / ; T Machiweni / ; R Mapanga /
Comments/Corrections
Comment In:
Nat Rev Cardiol. 2014 Oct;11(10):556   [PMID:  25154977 ]
N Engl J Med. 2014 Aug 14;371(7):677-9   [PMID:  25119614 ]
Nat Rev Nephrol. 2014 Oct;10(10):541   [PMID:  25157836 ]

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