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Kogure, Mana; Nakamura, Tomohiro; Tsuchiya, Naho; Hirata, Takumi; Nochioka, Kotaro; Narita, Akira; Hatanaka, Rieko; Itabashi, Fumi; Kanno, Ikumi; Obara, Taku; Satoh, Michihiro; Metoki, Hirohito; Miyagawa, Ken; Koshimizu, Hiroshi; Nagayoshi, Sho; Uruno, Akira; Kikuya, Masahiro; Suzuki, Kichiya; Nakaya, Naoki; Sugawara, Junichi; Kuriyama, Shinichi; Tsuji, Ichiro; Kure, Shigeo; Hozawa, Atsushi
Hypertension research, 05/2022, Volume: 45, Issue: 5Journal Article
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.
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