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Salt and potassium intake evaluated with spot urine and brief questionnaires in combination with blood pressure control status in hypertensive outpatients in a real-world setting

Hypertension Research volume 44, pages 1316–1325 (2021)Cite this article

A Correction to this article was published on 31 August 2021

This article has been updated

Abstract

Reducing salt and increasing potassium intake are recommended lifestyle modifications for patients with hypertension. The estimated 24-h urinary salt excretion value from spot urine using Tanaka’s formula and the salt check-sheet scores, questionnaire-based scores of salt intake, are practical indices of daily salt intake. However, few studies have evaluated salt intake with these methods in hypertensive outpatients. We examined salt and potassium intake with the spot urine method and the salt check-sheet scores of hypertensive outpatients in a multi-facility, real-world setting and examined whether the salt or potassium intake evaluated with these methods related to inadequate blood pressure control. Hypertensive outpatients from 12 medical facilities in the Okinawa prefecture were enrolled from November 2011 to April 2014 (n = 1559, mean age 63.9 years, 46% women). The mean blood pressure, urinary salt excretion value, urinary potassium excretion value, and total score on the salt check-sheet were 129/75 mmHg, 8.7 g/day, 1.6 g/day, and 10.4 points, respectively. The urinary salt excretion value and total score on the salt check-sheet but not urinary potassium excretion value were associated with inadequate blood pressure control (≥140/90 mmHg). Higher body mass index, estimated glomerular filtration rate, urinary potassium excretion value, total score on the salt check-sheet, and presence of inadequate blood pressure control were associated with high urinary salt excretion (≥10.2 g/day). In conclusion, hypertensive outpatients with high urinary salt excretion values estimated using Tanaka’s formula or with high scores on the salt check sheet may be candidates for more intensive salt reduction guidance.

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Acknowledgements

The authors are grateful for the cooperation from the staff of the collaborating medical facilities, particularly doctors T. Kikumura, N. Nagayoshi, M. Tomori, C. Imai, M. Matsuoka, and Y. Shinzato. The authors are also grateful to our clinical research coordinators, particularly M. Kobayashi and M. Nakahodo for retrieving data from the facilities and F. Aniya and K. Kohama for their excellent assistance as nutritionists.

Funding

This work was partly supported by the Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (grant number 2530891).

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Masanobu Yamazato, Akio Ishida, Tetsutaro Matayoshi & Yusuke Ohya

  2. Health Administration Center, University of the Ryukyus, Okinawa, Japan

    Atsushi Sakima

  3. Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan

    Kentaro Kohagura

  4. Shuri Jokamachi Clinic, Okinawa, Japan

    Takeshi Tana

  5. Yuuai Medical Center, Okinawa, Japan

    Masahiro Tamashiro

  6. Hata Medical Clinic, Okinawa, Japan

    Yoshio Hata

  7. Nishizaki Hospital, Okinawa, Japan

    Tamayo Naka

  8. Nakamura Medical Clinic, Okinawa, Japan

    Yoshito Nakamura

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  1. Masanobu Yamazato
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Contributions

MY, AS, and OY were involved in the conception and design of this article. MY, AS, AI, KK, TM, TT, YN, and OY were involved in planning and MY, AS, TT, MT, YH, TN, YN, and OY supervised the project at respective facilities. MY drafted and revised the manuscript. All authors discussed the results and contributed to the final manuscript.

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Correspondence to Masanobu Yamazato.

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The original online version of this article was revised: " plus the same explanatory text of the problem as in the erratum/correction article

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Yamazato, M., Sakima, A., Ishida, A. et al. Salt and potassium intake evaluated with spot urine and brief questionnaires in combination with blood pressure control status in hypertensive outpatients in a real-world setting. Hypertens Res 44, 1316–1325 (2021). https://doi.org/10.1038/s41440-021-00707-0

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