[Association of the combined estimated 24-h urinary Na/K ratio and body mass index with blood pressure: Cross-sectional data from the KOBE study].

Autor: Nozawa M; Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.; Saitama Branch of Japan Health Insurance Association., Kuwabara K; Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan., Kubota Y; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Hyogo, Japan., Nishida Y; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Osaka Institute of Public Health, Osaka, Japan., Kubo S; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Faculty of Human Sciences, Tezukayama Gakuin University, Osaka, Japan., Hirata T; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Department of Public Health, Hokkaido University Graduate School of Medicine, Hokkaido, Japan., Higashiyama A; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan., Hirata A; Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan., Hattori H; Graduate School of Health Management, Keio University, Kanagawa, Japan., Sata M; Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan., Kadota A; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Department of Public Health, Shiga University of Medical Science, Shiga, Japan., Sugiyama D; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Graduate School of Health Management, Keio University, Kanagawa, Japan.; Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan., Miyamatsu N; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan., Miyamoto Y; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.; Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan., Okamura T; Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.; Cohort Study Team, Center for Cluster Development and Coordination, Foundation for Biomedical Research and Innovation, Hyogo, Japan.
Jazyk: japonština
Zdroj: [Nihon koshu eisei zasshi] Japanese journal of public health [Nihon Koshu Eisei Zasshi] 2020; Vol. 67 (10), pp. 722-733.
DOI: 10.11236/jph.67.10_722
Abstrakt: Objective　Several studies have suggested that high dietary Na/K ratio and body mass index (BMI) increase the prevalence of hypertension. However, there have been a few reports on the combination of these two factors and their relationship with hypertension. This study aimed to examine the association of the combined estimated 24-h urinary Na/K ratio (24h-u-Na/K) (high or low) and BMI (high or low) with the risk of high blood pressure.Method　We performed a cross-sectional study involving 1,112 participants (340 men and 772 women) of the Kobe Orthopedic and Biomedical Epidemiological study (KOBE study) who had no cardiovascular diseases or current anti-hypertensive medications. Sex-specific analyses were performed. The 24h-u-Na/K ratio was calculated from an estimation formula using collected spot urine. Participants were divided into four groups based on their 24h-u-Na/K ratio (low or high) and BMI (low or high), with the cutoff points being the median and 25 kg/m 2 , respectively.　Participants with systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥80 mmHg were diagnosed with high blood pressure. Odds ratios (ORs) for high blood pressure according to the combined risks of high 24h-u-Na/K and BMI were examined with a logistic regression analysis.Results　The average SBP/DBP for men and women was 122.7/77.9 and 113.3/69.1 mmHg, respectively, and prevalence of high blood pressure among men and women was 47.4% and 21.3%, respectively. The mean BMI was 22.8 kg/m 2 for men and 20.9 kg/m 2 for women. The median 24h-u-Na/K was 3.2 for men and 3.1 for women. The prevalence of high blood pressure (men, women) was the highest in the group in which both 24h-u-Na/K and BMI were high (60.0%, 62.9%; men: P=0.273; women: P<0.001). In the same group, the multivariate-adjusted ORs for high blood pressure were significantly higher for both men (2.59; 95% confidence interval [CI]: 1.15-5.86) and women (10.78; 95% CI: 4.87-23.88) compared to the reference group with both factors classified as low. Women with low BMI but high 24h-u-Na/K also demonstrated a higher risk for high blood pressure (OR: 1.62; 95% CI: 1.10-2.40).Conclusion　The risk of high blood pressure was the highest when both BMI and 24h-u-Na/K were high. The current specific healthcare guidance in Japan is focused on obese individuals. However, in order to prevent hypertension more effectively, additional focus should be placed on the Na/K diet. Increased intake of vegetables and fruits and reduced intake of salt should be strongly recommended.
Databáze: MEDLINE
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