Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct 10;8(10):e75289.
doi: 10.1371/journal.pone.0075289. eCollection 2013.

Association between usual sodium and potassium intake and blood pressure and hypertension among U.S. adults: NHANES 2005-2010

Zefeng Zhang  1 , Mary E Cogswell, Cathleen Gillespie, Jing Fang, Fleetwood Loustalot, Shifan Dai, Alicia L Carriquiry, Elena V Kuklina, Yuling Hong, Robert Merritt, Quanhe Yang
Affiliations

Association between usual sodium and potassium intake and blood pressure and hypertension among U.S. adults: NHANES 2005-2010

Zefeng Zhang et al. PLoS One. .

Abstract

Objectives: 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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Adjusted systolic blood pressure (95% confidence interval) by 10th and 90th percentiles of potassium intake and age 20–29, 30–39, 40–49, 50–59, 60–69 and ≥70 years among adults aged ≥20 years who were not taking antihypertensive medication, NHANES 2005–2010.
Figure 2
Figure 2. Adjusted systolic blood pressure (95% confidence interval) by mid-value of quartile sodium, potassium intake and their ratio among adults aged ≥20 years who were not taking antihypertensive medication, NHANES 2005–2010.
See this image and copyright information in PMC

References

    1. Lawes CM, Vander Hoorn S, Ronders A (2008) International Society of Hypertension (2008) Global burden of blood-pressure-related disease, 2001. Lancet 371: 1513–1518. - PubMed
    1. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R (2002) Prospective Studies Collaboration (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360: 1903–1913. - PubMed
    1. American Heart Association (2010) Heart Disease and Stroke Statistics—2011 Update. Dallas, TX: American Heart Association. e19.
    1. Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, et al. (2011) Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation 123: 933–944. - PubMed
    1. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, et al. (2001) Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 344: 3–10. - PubMed

Publication types