Relationship between urinary sodium with blood pressure and hypertension among a Kazakh community population in Xinjiang, China

Abstract

Urinary sodium levels are reported to be associated with blood pressure in clinical trials and epidemiology studies. Nevertheless, the public health message of reducing sodium intake in free-living community populations remains under debate. Based on an ongoing prospective study initiated in 2012 with a community-based design in Xinjiang, China, 1668 adults (⩾30 years old) were assessed in the current study for associations between urinary sodium and blood pressure and hypertension in a free-living population of Kazakh people. After excluding 223 people on antihypertensive medication, 1445 participants were analyzed. Second urine samples after waking were used to estimate 24-h urinary sodium excretion, which is a marker for sodium intake. Following analyses, we found that the distribution of systolic and diastolic blood pressures moved upward with increasing quartiles of urinary sodium. After adjusting for age, differences in median systolic blood pressure were 8.5 mm Hg for men and 8.0 mm Hg for women between the top and bottom urinary sodium quartiles, and differences for diastolic blood pressure were 4.7 mm Hg for men and 4.3 mm Hg for women. A significant increased risk for hypertension was observed for the top quartile of urinary sodium after adjusting for age, body mass index, smoking, alcohol consumption, fruit and vegetable consumption, with corresponding odds ratios being 1.61 (95% confidence interval (CI): 1.02-2.54) for men and 1.92 (95% CI: 1.13-3.27) for women. Improving education about reducing salt intake is of particular public importance to reduce blood pressure and the risk for hypertension among the Kazakh people.

Cardiovascular Risk Factors and its Transition: An Ongoing Cohort Study in Chinese Kazakhs

“…Our study addressed a gap in intergroup variations in individual cardiovascular risk factor prevalence, which had several [21]. In addition to differences in genetic backgrounds, dietary intake of high salt and high fat appeared to be major environmental factors that contributed to high BP in this ethnic group, especially for Kazakh nomads; this is supported by this study and our previous study [13]. Besides rare intake of vegetable and fruit, salty air-dried meat and milk-tea were their indispensable daily food and beverage.…”

“…All strokes, hemorrhagic or ischemic, had evidence of computed tomography (CT) or magnetic resonance imaging (MRI Table 6. Relationship between estimated salt intake and high BP (also see our previous publication [13]). Table 7.…”

The association between dietary sodium intake, adiposity and sugar-sweetened beverages in children and adults: a systematic review and meta-analysis

“…Reasons for exclusion from metaanalyses included; findings were only presented as correlation coefficients (n=16) (35, 54-56, 61, 68, 77, 78, 81, 82, 84, 86, 87, 90, 92, 96) or as standardised regression coefficients (n=4) (57,64,89,94) , the exposure variable was presented as sodium density (n=2) (12,72) or 24-hr urinary sodium excretion was reported as sodium concentration (mmol/L) (74) or on a logarithmic scale (52,58) . Of the studies included in meta-analyses, 14 were from Asia (62,63,66,69,70,73,75,76,83,85,91,97,100,101) , eight from USA (10,11,59,60,71,88,102,103) , five from South and Central America (53,65,79,80,93) , four from Europe (9,67,95,99) , one from Samoa (98) and one included data collected across four countries (e.g. Japan, USA, UK, China) (104) .…”

“…Most of these studies (24/33) reported on more than one adiposity outcome (Table S3). Outcomes which were included in separate meta-analyses were BMI (n=31) (9-11, 53, 59, 60, 63, 65-67, 69-71, 73, 75, 76, 79, 80, 83, 85, 88, 93, 95, 97-104) , weight category (n=8) (9,11,63,73,91,97,103,104) , BW (n=7) (60,65,67,71,73,93,101) , WC (n=9) (9,65,66,70,73,75,80,83,100) and abdominal obesity (n=5) (62,66,73,102,103) . Only nine studies adjusted for energy intake (9,10,59,66,73,91,(102)(103)(104) and three studies adjusted for SSB intake (9,11,103) .…”

Paucity of high‐quality studies reporting on salt and health outcomes from the science of salt: A regularly updated systematic review of salt and health outcomes (April 2017 to March 2018)

“…Identified studies were meta‐analyses (n = 1), RCTs (n = 3), prospective cohort studies (n = 4), retrospective case–control studies (n = 1), cross‐sectional studies (n = 27), case–control studies (n = 1), post hoc analyses of RCTs (n = 2), and quasi‐experimental studies (n = 3). Three studies assessed morbidity outcomes, two studies assessed outcomes related to symptoms/quality of life/functional status, 31 studies assessed clinically relevant surrogate outcomes, including 26 that assessed blood pressure outcomes, and six studies assessed physiologic outcomes . Of these studies, only three studies met the minimum methodological criteria for detailed critical appraisal (Table ).…”