title: Association between usual sodium and potassium intake and blood pressure and hypertension among U.S. adults: NHANES 2005-2010.
abstract: OBJECTIVE
  Studies indicate high sodium and low potassium intake can increase blood pressure suggesting the ratio of sodium-to-potassium may be informative. Yet, limited studies examine the association of the sodium-to-potassium ratio with blood pressure and hypertension.
  
  
  METHODS
  We analyzed data on 10,563 participants aged ≥20 years in the 2005-2010 National Health and Nutrition Examination Survey who were neither taking anti-hypertensive medication nor on a low sodium diet. We used measurement error models to estimate usual intakes, multivariable linear regression to assess their associations with blood pressure, and logistic regression to assess their associations with hypertension.
  
  
  RESULTS
  The average usual intakes of sodium, potassium and sodium-to-potassium ratio were 3,569 mg/d, 2,745 mg/d, and 1.41, respectively. All three measures were significantly associated with systolic blood pressure, with an increase of 1.04 mmHg (95% CI, 0.27-1.82) and a decrease of 1.24 mmHg (95% CI, 0.31-2.70) per 1,000 mg/d increase in sodium or potassium intake, respectively, and an increase of 1.05 mmHg (95% CI, 0.12-1.98) per 0.5 unit increase in sodium-to-potassium ratio. The adjusted odds ratios for hypertension were 1.40 (95% CI, 1.07-1.83), 0.72 (95% CI, 0.53-0.97) and 1.30 (95% CI, 1.05-1.61), respectively, comparing the highest and lowest quartiles of usual intake of sodium, potassium or sodium-to-potassium ratio.
  
  
  CONCLUSIONS
  Our results provide population-based evidence that concurrent higher sodium and lower potassium consumption are associated with hypertension.
authors.affiliation: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Zefeng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Mary E
authors.initials: ME
authors.lastname: Cogswell
authors.forename: Cathleen
authors.initials: C
authors.lastname: Gillespie
authors.forename: Jing
authors.initials: J
authors.lastname: Fang
authors.forename: Fleetwood
authors.initials: F
authors.lastname: Loustalot
authors.forename: Shifan
authors.initials: S
authors.lastname: Dai
authors.forename: Alicia L
authors.initials: AL
authors.lastname: Carriquiry
authors.forename: Elena V
authors.initials: EV
authors.lastname: Kuklina
authors.forename: Yuling
authors.initials: Y
authors.lastname: Hong
authors.forename: Robert
authors.initials: R
authors.lastname: Merritt
authors.forename: Quanhe
authors.initials: Q
authors.lastname: Yang
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017419:Potassium, Dietary / Q000008:administration & dosage*; D012982:Sodium, Dietary / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D017419:Potassium, Dietary; D012982:Sodium, Dietary