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The association between urinary sodium excretion and blood pressure in a community-based population: the Yamagata (Takahata) study

  • Sayumi Watanabe
  • Tsuneo Konta
  • Kazunobu Ichikawa
  • Masafumi Watanabe
  • Kenichi Ishizawa
  • Yoshiyuki Ueno
  • Hidetoshi Yamashita
  • Takamasa Kayama
  • Isao Kubota
Original article

Abstract

Background

The association between salt intake and blood pressure levels is still inconclusive, and may be influenced by patient characteristics. We thus conducted a community-based cross-sectional study.

Methods

This study included 2297 subjects aged ≥ 40 years not on antihypertensive medication at the time of a health check-up. We examined the association between blood pressure levels and the estimated amount of 24-h urinary sodium excretion (e24hUNa) stratified by background characteristics. The 24-h urinary excretion levels of sodium and potassium were estimated from Kawasaki’s equation using a spot urine sample.

Results

The association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with e24hUNa was significantly positive in a multiple linear regression model adjusted for confounders including age, sex, smoking, alcohol consumption, body mass index, diabetes, hypercholesterolemia, renal function, and potassium excretion. The regression coefficients of changes in SBP and DBP per 1 SD increase in e24hUNa (53 mEq/day) were + 1.91 mmHg and + 0.94 mmHg, respectively. In the subgroup analyses, the increase in SBP was especially greater in the elderly, in subjects with diabetes, and in subjects with reduced renal function compared to those in the counterparts. The association between SBP and e24hUNa was insignificant in subjects with eGFR ≥ 90 ml/min/1.73m2, while the association with progression of renal dysfunction was stronger and significant.

Conclusions

These results demonstrated that the association between blood pressure and urinary sodium excretion was strengthened by characteristics of subjects such as aging, presence of diabetes, and renal impairment in the community-based population.

Keywords

Blood pressure Sodium General population 

Notes

Acknowledgements

This study was supported in part by a Grant in-Aid from the twenty-first Century Center of Excellence (COE) and Global COE program of the Japan Society for the Promotion of Science and by a Grant-in-Aid for Scientific Research (C) (15K09240) and (18K08229).

Compliance with ethical standards

Ethical approval

The institutional ethics committees of Yamagata University School of Medicine and the town of Takahata approved this study (Yamagata University, April, 2006, no. 1), and all subjects provided written informed consent. The procedures were performed in accordance with the Helsinki Declaration.

Conflict of interest

All authors declare no competing financial interests.

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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Sayumi Watanabe
    • 1
  • Tsuneo Konta
    • 1
    • 2
  • Kazunobu Ichikawa
    • 1
  • Masafumi Watanabe
    • 1
  • Kenichi Ishizawa
    • 3
  • Yoshiyuki Ueno
    • 3
  • Hidetoshi Yamashita
    • 3
  • Takamasa Kayama
    • 3
  • Isao Kubota
    • 1
    • 3
  1. 1.Department of Cardiology, Pulmonology and NephrologyYamagata University School of MedicineYamagataJapan
  2. 2.Department of Public Health and HygieneYamagata University Graduate School of Medical ScienceYamagataJapan
  3. 3.Global Center of ExcellenceYamagata University School of MedicineYamagataJapan

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