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Relationship between the urinary Na/K ratio, diet and hypertension among community-dwelling older adults

Hypertension Research volume 46, pages 556–564 (2023)Cite this article

Abstract

The association between the urinary sodium (Na)/potassium (K) ratio and hypertension is well recognized. We investigated whether the urinary Na/K ratio might be associated with hypertension in community-dwelling older adults and whether the association was influenced by habitual dietary patterns. We enrolled a total of 684 older adults (mean age, 76.8 years) and conducted health examinations at Kusatsu, Japan, in 2021. The urinary Na/K ratio was found to be independently associated with systolic blood pressure (SBP) (p < 0.0001), years of education (p = 0.0027), number of cohabitants (p = 0.0175), estimated glomerular filtrate rate (eGFR) (p = 0.0244), and Geriatric Depression Scale short-version (GDS15) score (p = 0.0366). In addition, an unsupervised hierarchical clustering analysis revealed a spectrum of habitual dietary patterns for higher and lower values of the urinary Na/K ratio. The decision tree indicated that the urinary Na/K ratio was associated with the history of milk consumption. A positive history of daily milk consumption predicted a mean urinary Na/K ratio of 2.8, and a negative history of daily milk consumption predicted a mean urinary Na/K ratio of 3.3. Furthermore, the frequency of fruit and vegetable consumption also predicted the urinary Na/K ratio. The relationship between the urinary Na/K ratio and hypertension was influenced by the frequency of consumption of milk, fruits, and vegetables in the subjects. This finding might be due to the influence of education and/or depression. The results suggested the importance of nutritional education in the development of hypertension.

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Acknowledgements

We would like to express our sincere appreciation to Toshiki Hata, Tomoya Sagara, and all other related parties in the Kusatsu Study who cooperated in this study.

Funding

All sources of support for this study were self-funded (Health Aging Innovation Center in Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology).

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Authors and Affiliations

  1. Departments of Nephrology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan

    Noriko Yamanaka, Mitsuyo Itabashi & Takashi Takei

  2. Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan

    Noriko Yamanaka, Yoshinori Fujiwara, Yu Nofuji, Takumi Abe, Akihiko Kitamura & Shoji Shinkai

  3. Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan

    Noriko Yamanaka & Toru Takebayashi

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  1. Noriko Yamanaka
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Correspondence to Takashi Takei.

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Yamanaka, N., Itabashi, M., Fujiwara, Y. et al. Relationship between the urinary Na/K ratio, diet and hypertension among community-dwelling older adults. Hypertens Res 46, 556–564 (2023). https://doi.org/10.1038/s41440-022-01135-4

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