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Consideration of the reference value and number of measurements of the urinary sodium-to-potassium ratio based on the prevalence of untreated home hypertension: TMM Cohort Study

2022; Springer Nature; Volume: 45; Issue: 5 Linguagem: Inglês

10.1038/s41440-021-00843-7

1348-4214

Mana Kogure, Tomohiro Nakamura, Naho Tsuchiya, Takumi Hirata, Kotaro Nochioka, Akira Narita, Rieko Hatanaka, Fumi Itabashi, Ikumi Kanno, Taku Obara, Michihiro Satoh, Hirohito Metoki, Ken Miyagawa, Hiroshi Koshimizu, Sho Nagayoshi, Akira Uruno, Masahiro Kikuya, Kichiya Suzuki, Naoki Nakaya, Junichi Sugawara, Shinichi Kuriyama, Ichiro Tsuji, Shigeo Kure, Atsushi Hozawa,

Nutritional Studies and Diet

Abstract The sodium-to-potassium (Na/K) ratio is known to be associated with blood pressure (BP). However, no reference value has been established since the urinary Na/K (uNa/K) ratio is known to have diurnal and day-to-day variations. Therefore, we investigated the number of days required to yield a better association between the morning uNa/K ratio and home BP (HBP) and determined a morning uNa/K ratio value that can be used as a reference value in participants who are not taking antihypertensive medication. This was a cross-sectional study using data from the Tohoku Medical Megabank Project Cohort Study. A total of 3122 participants borrowed HBP and uNa/K ratio monitors for 10 consecutive days. We assessed the relationship between the morning uNa/K ratio from 1 day to 10 days and home hypertension (HBP ≥ 135/85 mmHg) using multiple logistic regression models. Although a 1-day measurement of the morning uNa/K ratio was positively associated with home hypertension, multiple measurements of the morning uNa/K ratio were strongly related to home hypertension. The average morning uNa/K ratio was relatively stable after 3 days (adjusted odds ratio of home hypertension per unit increase in the uNa/K ratio for more than 3 days: 1.19–1.23). In conclusion, there was no threshold for the uNa/K ratio, and the morning uNa/K ratio was linearly associated with home hypertension. The Na/K ratio 2.0 calculated from the Dietary Reference Intakes for Japanese might be a good indication. Regarding the stability of the association between the morning uNa/K ratio and BP, more than 3 days of measurements is desirable.