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Swiss Med Wkly. 2017 Feb 17;147:w14411. doi: 10.4414/smw.2017.14411. eCollection 2017.

Associations of sodium, potassium and protein intake with blood pressure and hypertension in Switzerland.

Author information

1
Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital, Switzerland.
2
Community Prevention Unit, Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
3
Department of Medicine, University Hospital, Basel, Switzerland.
4
Hypertension Centre, Luzerner Kantonsspital, Luzern, Switzerland.
5
Unit of Hypertension, Departments of Specialties of Medicine and Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland.
6
Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland.
7
Division of Nephrology, Ospedale Carità, Locarno, Switzerland.
8
Praxis für Innere Medizin, Vezia, Switzerland.
9
Cardiology Deptartment, Ospedale San Giovanni, Bellinzona, Switzerland.
10
Department of Internal Medicine and Angiology, Hôpital Cantonal de Fribourg, Switzerland.
11
Nephrology/Transplantation Medicine, Kantonsspital, St Gallen, Switzerland.
12
Clinic and Policlinic of Internal Medicine, University Hospital of Zurich, Switzerland.

Abstract

BACKGROUND:

Nutritional factors play an important role in the regulation of blood pressure and in the development of hypertension. In this analysis, we explored the associations of 24-hour urinary Na+, K+ and urea excretion with blood pressure levels and the risk of hypertension in the Swiss population, taking regional linguistic differences into account.

METHODS:

The Swiss Survey on Salt is a population based cross-sectional study that included 1336 subjects from the three main linguistic regions (French, German and Italian) of Switzerland. Blood pressure was measured with a validated oscillometric Omron HEM 907 device. Hypertension was defined as current antihypertensive treatment or a mean systolic blood pressure >140 mm Hg and/or diastolic >90 mm Hg, based on eight blood pressure measurements performed at two visits. Na+, K+ and urea excretion were assessed in 24-hour urine collections. We use multiple logistic/linear regressions to explore the associations of urine Na+, K+ and urea with blood pressure / hypertension, taking into account potential confounders and effect modifiers.

RESULTS:

The prevalence of hypertension was 30%, 26% and 17% in the German-, French- and Italian- speaking regions respectively, (p-value across regions <0.001). In the Swiss adult population, besides age, sex, and body mass index, urinary Na+ excretion was positively associated with systolic blood pressure and hypertension. Urinary K+ excretion tended to be negatively associated with blood pressure but this was not significant (p = 0.08). Hypertensive people had a higher 24-hour urinary Na+/K+ ratio than normotensive people (p = 0.003). Urinary urea excretion was associated with neither blood pressure nor hypertension. Participants from the German-speaking region had a higher likelihood of having a high systolic blood pressure.

CONCLUSIONS:

We confirm a high prevalence of elevated blood pressure in Swiss adults, including regional differences. In Switzerland, urinary Na+ excretion is associated positively with blood pressure and hypertension, independently of urinary K+ and urea excretion. The observed differences in blood pressure levels across linguistic regions are independent of the urinary Na+, K+ and urea excretion.

PMID:
28322418
DOI:
10.4414/smw.2017.14411
[Indexed for MEDLINE]
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