European Journal of Nutrition

, Volume 58, Issue 4, pp 1659–1671 | Cite as

High sodium intake and sodium to potassium ratio may be linked to subsequent increase in vascular damage in adults aged 40 years and older: the Korean multi-rural communities cohort (MRCohort)

  • Sukyoung Jung
  • Mi Kyung KimEmail author
  • Jinho Shin
  • Bo Youl Choi
  • Young-Hoon Lee
  • Dong Hoon Shin
  • Min-Ho Shin
Original Contribution



Subclinical vascular damage is a chronic intermediate process in cardiovascular disease (CVD) and high sodium (Na) has been regarded as an adverse factor in subclinical vascular health; however, the longitudinal relationship between Na intake and subclinical vascular damage has not been studied. We aimed to evaluate the longitudinal relationship of dietary Na intake and sodium to potassium ratio (Na:K) with brachial-ankle pulse wave velocity (baPWV) and carotid intima media thickness (cIMT) in healthy adults aged 40 years and older in Korea.


The present study was based on participants (n = 2145 for baPWV analysis and n = 2494 for cIMT analysis) who visited three times during 2005–2013 (median 5.3 years of follow-up). We used both dietary Na intake and Na:K at baseline and its average (baseline, 2nd, 3rd), which was obtained from food frequency questionnaire (FFQ) as exposure at every visit. baPWV and cIMT levels at the third visit and change from baseline to the third visit were used to represent the level of subclinical vascular damage.


After adjustment for potential confounders, significant positive relationships between dietary Na intake and both baPWV3rd and cIMT3rd were observed (baPWV: p for trend ≤ 0.0001 for Naaverage; cIMT: p for trend = 0.013 for Naaverage). Compared with Na:Ks less than 1.0, the levels of both baPWV and cIMT were higher for participants with Na:Ks over 1.0 (baPWV: p for trend = 0.0002 for Na:Kaverage; cIMT: p for trend = 0.005 for Na:Kaverage). Similar significant trends were shown in relationships between dietary Na intake and Na:K and changes in baPWV and cIMT levels.


In conclusion, dietary Na intake and Na:K may be positively linked to subsequent baPWV and cIMT levels in adults aged 40 years and older in Korea. Our findings may provide informative evidence on subclinical vascular damage, particularly for populations with relatively high dietary Na intake and low dietary K intake.


Sodium intake Subclinical vascular damage Carotid intima media thickness Brachial-ankle pulse wave velocity Longitudinal study 



This work was supported by a National Research Foundation of Korea (NRF) Grant funded by the Korean government (Ministry of Science, ICT and Future Planning; no. 2016R1A2B2011352) and by the Research Program funded by the Korea Centers for Disease Control and Prevention (2004-E71004-00, 2005-E71011-00, 2006-E71009-00, 2007-E71002-00, 2008-E71004-00, 2009-E71006-00, 2010-E71003-00, 2011-E71002-00, 2012-E71007-00, and 2013-E71008-00). The funders played no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.

Author contributions

Conceived and designed the experiments: MKK, BYC, JS, YHL, DHS, MHS. Formal analysis: SJ. Investigation: SJ, MKK. Methodology: MKK. Project administration: BYC. Supervision: MKK. Validation: MKK, BYC, JS, YHL, DHS, MHS. Writing—original draft: SJ, MKK. Writing—review and editing: SJ, MKK.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Institutional Review Board of Hanyang University) and with the Helsinki Declaration of 1964, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

Supplementary material

394_2018_1712_MOESM1_ESM.docx (98 kb)
Supplementary material 1 (DOCX 98 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Health Care Policy ResearchKorea Institute for Health and Social AffairsSejongSouth Korea
  2. 2.Institute for Health and SocietyHanyang UniversitySeoulSouth Korea
  3. 3.Department of Preventive Medicine, College of MedicineHanyang UniversitySeoulSouth Korea
  4. 4.Division of Cardiology, Department of Internal Medicine, College of MedicineHanyang UniversitySeoulSouth Korea
  5. 5.Department of Preventive Medicine and Institute of Wonkwang Medical ScienceWonkwang University College of MedicineIksanSouth Korea
  6. 6.Department of Occupational and Environmental MedicineKeimyung University Dongsan Medical CenterDaeguSouth Korea
  7. 7.Department of Preventive MedicineChonnam National University Medical SchoolGwangjuSouth Korea

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