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Serum sodium and risk of hypertension: a cohort study

Hypertension Research volume 45, pages 354–359 (2022)Cite this article

Abstract

This study aimed to investigate the cross-sectional association between serum sodium and blood pressure at baseline and, more importantly, investigate the prospective association between serum sodium and the risk of incident hypertension. We used data from 1 638 workers aged 18 to 71 years who participated in 2015–2016 survey of the Furukawa Nutrition and Health Study. During a maximum follow-up of 3 years, 229 participants developed hypertension. Multivariable linear regression models were used to evaluate the cross-sectional association. The Cox proportional hazards model was used to calculate the hazard ratio and 95% confidence interval of incident hypertension across quartiles of serum sodium (137–140, 141–142, 143, and 144–147 mmol/L). In the cross-sectional analysis, we did not observe a significant association between serum sodium and blood pressure at baseline. In the prospective analysis, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident hypertension were 1.03 (0.71–1.51), 1.35 (0.87–2.08), and 1.46 (0.97–2.20) for the upper three quartiles of the serum sodium levels compared with the lowest quartile (P for trend=0.02). When serum sodium was treated as a continuous variable, the multivariable-adjusted hazard ratio for hypertension was 1.10 (1.03–1.18). The association was slightly attenuated after additionally adjusting for baseline blood pressure, with a hazard ratio of 1.08 (1.00–1.16) for a 1 mmol/L increase in serum sodium. In conclusion, an elevated serum sodium level was associated with an increased risk of developing hypertension, suggesting that serum sodium could be a potential risk factor for hypertension.

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Acknowledgements

We are grateful to the study participants for their cooperation and participation. We thank Maki Konishi and Rika Osawa (National Center for Global Health and Medicine) for their help in data collection.

Funding

This study was supported by the Grant-in-Aid for Scientific Research (B) (25293146), Grant-in-Aid for Young Scientists (A) (25702006), and Grant-in-Aid for Research Activity Start-up (19K24247) from the Japan Society for the Promotion of Science, Japan, and a research grant from the Industrial Health Foundation, Japan. This work was also supported by the Health and Labour Sciences Research Expenses for Commission (Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus H26005).

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Authors and Affiliations

  1. Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

    Huan Hu, Graham A. Macgregor & Feng J. He

  2. Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan

    Huan Hu, Takako Miki, Akiko Nanri & Tetsuya Mizoue

  3. Research Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health, Kanagawa, Japan

    Huan Hu

  4. Furukawa Electric Co., Ltd., Tokyo, Japan

    Masafumi Eguchi & Takeshi Kochi

  5. KUBOTA Corporation Co., Ltd., Ibaraki, Japan

    Isamu Kabe

  6. Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women’s University, Fukuoka, Japan

    Akiko Nanri

Authors
  1. Huan Hu
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  2. Masafumi Eguchi
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  3. Takako Miki
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  4. Takeshi Kochi
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  5. Isamu Kabe
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  6. Akiko Nanri
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  7. Graham A. Macgregor
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  8. Tetsuya Mizoue
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  9. Feng J. He
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Corresponding author

Correspondence to Huan Hu.

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Conflict of interest

FJH is a member of Consensus Action on Salt & Health (CASH) and World Action on Salt & Health (WASH). Both CASH and WASH are nonprofit charitable organizations, and FJH does not receive any financial support from CASH or WASH. GAM is Chairman of Blood Pressure UK (BPUK), CASH, WASH and Action on Sugar. BPUK, CASH, WASH and Action on Sugar are nonprofit charitable organizations. GAM does not receive any financial support from any of these organizations. ME and TK are health professionals at the Furukawa Electric Corporation. IK is a health professional in the KUBOTA Corporation. HH, T Miki, AN, and T Mizoue declare no competing interests.

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Hu, H., Eguchi, M., Miki, T. et al. Serum sodium and risk of hypertension: a cohort study. Hypertens Res 45, 354–359 (2022). https://doi.org/10.1038/s41440-021-00797-w

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