Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003-2017

Br J Nutr. 2021 Jan 14;125(1):79-91. doi: 10.1017/S000711452000269X. Epub 2020 Jul 17.

Abstract

Few studies have reported associations between the Na:K ratio and risk factors related to CVD among the general population in Asian countries. This study aimed to investigate the dietary Na:K ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48 800 Japanese participants (19 386 men and 29 414 women) aged ≥20 years, registered in the 2003-2017 National Health and Nutrition Survey. Multivariate OR and 95 % CI for risk of hypertension, high glycated HbA1c levels, hypercholesterolaemia, low serum levels of HDL-cholesterol and high non-HDL-cholesterol levels according to the Na:K ratio were estimated using logistic regression models. Dietary Na:K ratio decreased for both men and women from 2003 to 2017. Higher Na:K ratio and higher hypertension prevalence were observed (multivariate OR (fifth v. first quintiles) 1·27, 95 % CI 1·15, 1·40; Pfor trend < 0·001 for men and 1·12, 95 % CI 1·01, 1·23; Pfor trend = 0·007 for women). Higher Na:K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR 1·56, 95 % CI 1·24, 1·96). Prevalence of low HDL-cholesterol levels was increased with higher Na:K ratio (Pfor trend =0·002 for men and <0·001 for women). No significant associations were found between Na:K ratio and hypercholesterolaemia in men or high non-HDL-cholesterol levels in both men and women. Our findings suggest that dietary Na:K ratio is associated with several CVD risk factors among Japanese adults.

Keywords: CVD risk factors; Japan; National Health and Nutrition Survey (NHNS); Potassium; Sodium.

MeSH terms

  • Adult
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Diet / adverse effects
  • Diet / statistics & numerical data*
  • Female
  • Glycated Hemoglobin / analysis
  • Heart Disease Risk Factors
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypercholesterolemia / etiology
  • Hypertension / epidemiology
  • Hypertension / etiology
  • Japan / epidemiology
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Nutrition Surveys
  • Potassium, Dietary / analysis*
  • Prevalence
  • Retrospective Studies
  • Sodium, Dietary / analysis*
  • Young Adult

Substances

  • Cholesterol, HDL
  • Glycated Hemoglobin A
  • Potassium, Dietary
  • Sodium, Dietary
  • hemoglobin A1c protein, human
  • Cholesterol