title: Association of urinary sodium and potassium excretion with blood pressure.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.affiliation: The authors' affiliations are listed in the Appendix.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mente
authors.forename: Martin J
authors.initials: MJ
authors.lastname: O'Donnell
authors.forename: Sumathy
authors.initials: S
authors.lastname: Rangarajan
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: McQueen
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
authors.forename: Andreas
authors.initials: A
authors.lastname: Wielgosz
authors.forename: Howard
authors.initials: H
authors.lastname: Morrison
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xingyu
authors.initials: X
authors.lastname: Wang
authors.forename: Chen
authors.initials: C
authors.lastname: Di
authors.forename: Prem
authors.initials: P
authors.lastname: Mony
authors.forename: Anitha
authors.initials: A
authors.lastname: Devanath
authors.forename: Annika
authors.initials: A
authors.lastname: Rosengren
authors.forename: Aytekin
authors.initials: A
authors.lastname: Oguz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zatonska
authors.forename: Afzal Hussein
authors.initials: AH
authors.lastname: Yusufali
authors.forename: Patricio
authors.initials: P
authors.lastname: Lopez-Jaramillo
authors.forename: Alvaro
authors.initials: A
authors.lastname: Avezum
authors.forename: Noorhassim
authors.initials: N
authors.lastname: Ismail
authors.forename: Fernando
authors.initials: F
authors.lastname: Lanas
authors.forename: Thandi
authors.initials: T
authors.lastname: Puoane
authors.forename: Rafael
authors.initials: R
authors.lastname: Diaz
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Romaina
authors.initials: R
authors.lastname: Iqbal
authors.forename: Rita
authors.initials: R
authors.lastname: Yusuf
authors.forename: Jephat
authors.initials: J
authors.lastname: Chifamba
authors.forename: Rasha
authors.initials: R
authors.lastname: Khatib
authors.forename: Koon
authors.initials: K
authors.lastname: Teo
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D004032:Diet; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000652:urine; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000008:administration & dosage / Q000652:urine*; D012680:Sensitivity and Specificity; D012964:Sodium / Q000652:urine*; D012982:Sodium, Dietary / Q000008:administration & dosage
chemical_list: D012982:Sodium, Dietary; D012964:Sodium; D011188:Potassium