Targeting the Dietary Na:K Ratio—Considerations for Design of an Intervention Study to Impact Blood Pressure

Baer, David J.; Althouse, Andrew D.; Hermann, Mindy; Johnson, Janice; Maki, Kevin C.; Marklund, Matti; Vogt, Liffert; Wesson, Donald E.; Stallings, Virginia A.

doi:10.1093/advances/nmab099

Cited by 11 publications

(5 citation statements)

References 32 publications

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“…These findings suggested that a urinary Na/K ratio reduction over the long term might promote a reduction in BP among older adults. Therefore, future studies are required to further examine the association between a Na/K ratio reduction and a BP reduction in later life [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in the Urinary Sodium-to-Potassium Ratio Are Associated with Blood Pressure Change in Older Japanese Adults: A 7-Year Longitudinal Study

Abe

Endo²,

Hamano³

et al. 2022

JCM

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Studies on the association between sodium-to-potassium (Na/K) ratio changes and blood pressure (BP) changes among older adults are limited. This 7-year longitudinal study examined the association between Na/K ratio changes (evaluated using spot urine tests) and BP changes among older Japanese adults. Data were collected from 432 participants (mean age: 70.3±4.4; range: 65–84 years) in 2012 and 2019. Changes in BP and the Na/K ratio over 7 years were calculated by subtracting baseline values from values noted during a follow-up survey. The median systolic and diastolic BP (SBP) and (DBP) changes after 7 years were 4 (IQR, −7, 14) and −1 (IQR, −9, 5) mmHg, respectively. The median Na/K ratio was changed during the follow-up period by −0.2 (IQR, −1.3, 0.7). A generalized linear model indicated that Na/K ratio changes were positively associated with SBP (B = 2.03, p < 0.001) and DBP (B = 0.62, p = 0.021) changes. In the non-antihypertensive medication-using group, urinary Na/K ratio changes were associated with SBP and DBP changes (B = 2.39, p = 0.001; B = 0.99, p = 0.033). In the antihypertensive medication user group, urinary Na/K ratio changes were associated with SBP changes (B = 1.62, p = 0.015). We confirmed the association between changes in the Na/K ratio and changes in BP.

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Section: Discussionmentioning

confidence: 99%

Changes in the Urinary Sodium-to-Potassium Ratio Are Associated with Blood Pressure Change in Older Japanese Adults: A 7-Year Longitudinal Study

Abe

Endo²,

Hamano³

et al. 2022

JCM

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“…First, our study focused on the effect of a high-K + diet on blood pressure by evaluating renal Na + transporters along the nephron without measuring blood pressure itself. Second, the ratio of Na + to K + , rather than the Na + /K + intake, is reportedly necessary for volume and blood pressure homeostasis [32]. As shown recently, the urinary Na + /K + ratio was found to exhibit a significantly stronger relationship with blood pressure compared with BP than Na + or K + alone [33].…”

Section: Discussionmentioning

confidence: 90%

Defective natriuresis contributes to hyperkalemia in db/db mice during potassium supplementation

Shu,

Gao,

Mao

et al. 2024

Journal of Hypertension

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Objectives: Potassium supplementation reduces blood pressure and the occurrence of cardiovascular diseases, with K+-induced natriuresis playing a potential key role in this process. However, whether these beneficial effects occur in diabetes remains unknown. Methods: In this study, we examined the impact of high-K+ intake on renal Na+/K+ transport by determining the expression of major apical Na+ transporters, diuretics responses (as a proxy for specific Na+ transporter function), urinary Na+/K+ excretion, and plasma Na+/K+ concentrations in db/db mice, a model of type 2 diabetes mellitus. Results: Although db/m mice exhibited increased fractional excretion of sodium (FENa) and fractional excretion of potassium (FEK) under high-K+ intake, these responses were largely blunted in db/db mice, suggesting impaired K+-induced natriuresis and kaliuresis in diabetes. Consequently, high-K+ intake increased plasma K+ levels in db/db mice, which could be attributed to the abnormal activity of sodium-hydrogen exchanger 3 (NHE3), sodium-chloride cotransporter (NCC), and epithelial Na+ channel (ENaC), as high-K+ intake could not effectively decrease NHE3 and NCC and increase ENaC expression and activity in the diabetic group. Inhibition of NCC by hydrochlorothiazide could correct the hyperkalemia in db/db mice fed a high-K+ diet, indicating a key role for NCC in K+-loaded diabetic mice. Treatment with metformin enhanced urinary Na+/K+ excretion and normalized plasma K+ levels in db/db mice with a high-K+ diet, at least partially, by suppressing NCC activity. Conclusion: Collectively, the impaired K+-induced natriuresis in diabetic mice under high-K+ intake may be primarily attributed to impaired NCC-mediated renal K+ excretion, despite the role of NHE3.

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“…Ma et al (2022) showed that higher sodium and lower potassium intakes were associated with a higher cardiovascular risk. Therefore, increasing potassium intake and reducing sodium intake is required, with a call for attention to the diet's Na:K ratio (Baer et al, 2022). The RDAs of sodium and potassium were 1,000-1,500 mg/day and 2,000-3,400 mg/day, respectively (National Academies of Sciences Engineering and Medicine, 2019).…”

Section: Discussionmentioning

confidence: 99%

Leaf elemental composition analysis in spider plant [Gynandropsis gynandra L. (Briq.)] differentiates three nutritional groups

et al. 2022

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Understanding the genetic variability within a plant species is paramount in implementing a successful breeding program. Spider plant (Gynandropsis gynandra) is an orphan leafy vegetable and an extraordinary source of vitamins, secondary metabolites and minerals, representing an important resource for combatting malnutrition. However, an evaluation of the leaf elemental composition, using a worldwide germplasm collection to inform breeding programs and the species valorization in human nutrition is still lacking. The present study aimed to profile the leaf elemental composition of G. gynandra and depict any potential geographical signature using a collection of 70 advanced lines derived from accessions originating from Asia and Eastern, Southern and West Africa. The collection was grown in a greenhouse using a 9 × 8 alpha lattice design with two replications in 2020 and 2021. Inductively coupled plasma–optical emission spectrometry was used to profile nine minerals contents. A significant difference (p < 0.05) was observed among the lines for all nine minerals. Microelements such as iron, zinc, copper and manganese contents ranged from 12.59–430.72, 16.98–166.58, 19.04–955.71, 5.39–25.10 mg kg−1 dry weight, respectively, while the concentrations of macroelements such as potassium, calcium, phosphorus and magnesium varied in the ranges of 9992.27–49854.23, 8252.80–33681.21, 3633.55–14216.16, 2068.03–12475.60 mg kg−1 dry weight, respectively. Significant and positive correlations were observed between iron and zinc and calcium and magnesium. Zinc, calcium, phosphorus, copper, magnesium, and manganese represented landmark elements in the genotypes. Eastern and Southern African genotypes were clustered together in group 1 with higher phosphorus, copper and zinc contents than Asian and West African lines, which clustered in group 2 and were characterized by higher calcium, magnesium and manganese contents. An additional outstanding group 3 of six genotypes was identified with high iron, zinc, magnesium, manganese and calcium contents and potential candidates for cultivar release. The genotype × year interaction variance was greater than the genotypic variance, which might translate to phenotypic plasticity in the species. Broad-sense heritability ranged from low to high and was element-specific. The present results reveal the leaf minerals diversity in spider plant and represent a baseline for implementing a minerals-based breeding program for human nutrition.

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Targeting the Dietary Na:K Ratio—Considerations for Design of an Intervention Study to Impact Blood Pressure

Cited by 11 publications

References 32 publications

Changes in the Urinary Sodium-to-Potassium Ratio Are Associated with Blood Pressure Change in Older Japanese Adults: A 7-Year Longitudinal Study

Changes in the Urinary Sodium-to-Potassium Ratio Are Associated with Blood Pressure Change in Older Japanese Adults: A 7-Year Longitudinal Study

Defective natriuresis contributes to hyperkalemia in db/db mice during potassium supplementation

Leaf elemental composition analysis in spider plant [Gynandropsis gynandra L. (Briq.)] differentiates three nutritional groups

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