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Lower 24-h urinary sodium excretion is associated with hypertension control: the 2010 Heart Follow-Up Study

Journal of Human Hypertension volume 34, pages 624–632 (2020)Cite this article

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Abstract

Among individuals with hypertension, controlling high blood pressure (BP) reduces the risk for cardiovascular events and death. Reducing dietary sodium can help achieve BP control. The study aim was to use a population-based sample utilizing the gold standard for urinary sodium to quantify the degree with which sodium was independently associated with BP control among individuals with hypertension. Participants included 1568 adults from the Heart Follow-Up Study, a New York City population-based representative study conducted in 2010. Participants collected urine for 24 h and had BP and other anthropometrics measured. Hypertension was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or being on BP lowering medication. Sodium intake (mg/day) was measured from a single 24-h urine collection. Hypertension prevalence was 30.8%. Among those with hypertension, 64.6% were aware, 56.3% were treated, and 40.3% were controlled. Among those treated for hypertension, 73.0% were controlled. Mean sodium intake among those with hypertension was 3564 mg/day. From multivariable adjusted logistic regression models, each 500 mg decrease in 24-h urinary sodium excretion was associated with a 18% higher odds of hypertension control among those with hypertension (1.18, 95% CI: 1.07, 1.30). In New York City, approximately one in three people has hypertension with a majority uncontrolled. Sodium intake among those with hypertension was 55% greater than recommended upper limit of 2300 mg per day. Among individuals with hypertension, lower sodium intake was associated with hypertension control.

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Funding

The HFUS was supported by funding from the Robert Wood Johnson Foundation, the New York State Health Foundation, the National Association of County & City Health Officials and the Centers for Disease Control and Prevention [Grant Number 5U38HM000449-02], the W.K. Kellogg Foundation, and the U.S. Department of Health and Human Services. This funding is administered by the Fund for Public Health in New York, a private nonprofit organization that supports innovative initiatives of the NYC DOHMH. This research was supported in part by NIH Grants R01HL077809 from the National Heart, Lung, and Blood Institute, and the U54MD000538 from the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of the funders.

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Authors and Affiliations

  1. Department of Public Health Sciences, University of Miami, Miami, FL, USA

    Tali Elfassy

  2. New York City Department of Health and Mental Hygiene, Long Island City, NY, USA

    Shadi Chamany, Katherine Bartley & Sonia Y. Angell

  3. Department of Population Health, NYU School of Medicine, New York, NY, USA

    Stella S. Yi

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  1. Tali Elfassy
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Correspondence to Tali Elfassy.

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Elfassy, T., Chamany, S., Bartley, K. et al. Lower 24-h urinary sodium excretion is associated with hypertension control: the 2010 Heart Follow-Up Study. J Hum Hypertens 34, 624–632 (2020). https://doi.org/10.1038/s41371-019-0285-9

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