Urinary sodium excretion and its association with blood pressure in Nigeria: A nationwide population survey

Abstract

Assessment of level of salt intake in a population is the first step toward planning strategies aimed at salt reduction. As a surrogate of salt intake, we measured a single 24-hour urine sodium (uNa) of free-living 2503 adults in a nationally representative sample of Nigerians drawn from 12 rural and urban communities; and evaluated the community-level association of uNa with blood pressure (BP). Overall, the median (interquartile range (IQR)) of uNa was 99 (105) mmol, ranging from 23.8 (32.4) in rural north-central to 172.8 (131.0) mmol in urban northwestern region. Daily uNa was significantly higher (p < .001) in men compared to women (107.1 vs 93.9 mmol); and urban compared to rural dwellers (114.9 vs 86.0mmol). About one-half of participants excreted uNa in excess of recommended daily maximum value (86mmol). In a model adjusted for age, sex, body mass index (BMI), level of education, place of residence, and use of antihypertensive medication; being a man (odds ratio, OR 1.69, 95% confidence Interval CI, 1.21-2.37, p = .002) and being < 60 years of age (OR 1.74, 95% CI 1.23-2.45, p = .002), were associated with excreting higher than recommended uNa. | 2267 ODILI et aL.

Reply to comment on: Urinary sodium excretion and its association with blood pressure in Nigeria: A nationwide population survey

“…As noted in our article 2 the urinary creatinine value was lower than that reported in the literature. 6 We are convinced that the poor nutrition status of individuals residing in both rural and urban areas included in our study was responsible for this.…”

“…

We thank Khitan and colleagues 1 for their comments on our recent article. 2 We discussed some of the issues raised in the limitations section of the article; however, we wish to offer further explanations. Khitan and colleagues were concerned about the interpretation of our findings in terms of reverse causality.

…”

Hyperhomocysteinemia and its Relations to Conventional Risk Factors for Cardiovascular Diseases in Adult Nigerians: The REMAH Study.

“…Participants of the current study were of a sub-sample of adult Nigerians aged 18 years and above that participated in the Removing the Mask on Hypertension (REMAH) Study 11,12 . REMAH was a nationwide study that surveyed hypertension and its risk factors in the six geopolitical zones of Nigeria.…”

“…Hypothesis stimulated by recent evidence 10 indicates that the therapeutic benefit of homocysteine lowering may be affected by its interaction with other risk factors of hypertension or CVD, hence may vary from population to population. 11 In Nigeria, 38% of its adult population are hypertensive, of whom control of blood pressure is achieved only in 12% and knowledge of the burden of hyperhomocysteinemia is uncertain. The present study was aimed at evaluating the burden of hyperhomocysteinemia among adult Nigerians and also to assess the relation of homocysteine with hypertension and established risk factors of CVD.…”

The need for accurate estimation of sodium intake in nutritional studies

“…We read with interest the study by Odili et al “Urinary sodium excretion and its association with blood pressure in Nigeria: A nationwide population survey”. 1 We applaud the researchers' technique in obtaining a nationwide representative sample to include subjects from various geopolitical zones and different communities. We agree with the authors that such studies are highly needed and are of utmost importance in the sub‐Saharan African region especially that hypertension is a major player in cardiovascular disease outcomes and is expected to be of the salt‐sensitive type in this population.…”