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<p>Recent studies indicate a stronger association between the urinary sodium-to-potassium (Na/K) ratio and blood pressure (BP) than individual sodium (Na) or potassium (K) levels. This study aimed to examine whether urinary Na/K ratio could predict the onset of hypertension in the general population. The ratio was calculated using overnight urine samples from 23,014 adults (mean age; 51.4 ± 13.2 years, 13,525 men) who underwent annual physical checkups between 2010 and 2023. Cross-sectional analysis of first-visit data revealed significantly higher Na/K ratios among individuals with hypertension compared to normotensive individuals (5.05 ± 2.85 vs. 4.39 ± 2.47, <i>p</i> &lt; 0.001). Multiple regression analysis showed a significant association between the Na/K ratio and systolic BP. After excluding participants with hypertension, 12,483 normotensive individuals (48.7 ± 11.9 years; 7087 men) were followed for a median of 1788 days. During the follow-up period, 4056 participants developed hypertension. Kaplan–Meier analysis indicated an increased risk of hypertension across baseline Na/K ratio quartiles (log-rank, <i>p</i> &lt; 0.001). Univariate Cox regression analysis identified the Na/K ratio as a significant predictor of incident hypertension, with hazard ratios increasing across quartiles. Multivariate analysis confirmed the association (hazard ratio [HR] = 1.408, 95% confidence interval [CI]; 1.225–1.619), although the Na/K ratio was not independently associated with hypertension onset after additional adjustment for baseline systolic BP. These findings suggest that the urinary Na/K ratio is significantly associated with the risk of hypertension in the general population. Therefore, dietary interventions that lower the Na/K ratio may prevent the development of hypertension.</p><p></p>

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Prediction of future development of hypertension in the general population using urinary Na/K ratio

  • 期刊论文

  • 发表日期：

    2026年2月10日

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  • Sumiyo Yamashita,
  • Hiroyuki Takase,
  • Tateo Okado,
  • Gaku Matsukura,
  • Naomi Kawakatsu,
  • Fumihiko Kin,
  • Yasuaki Dohi

摘要

Recent studies indicate a stronger association between the urinary sodium-to-potassium (Na/K) ratio and blood pressure (BP) than individual sodium (Na) or potassium (K) levels. This study aimed to examine whether urinary Na/K ratio could predict the onset of hypertension in the general population. The ratio was calculated using overnight urine samples from 23,014 adults (mean age; 51.4 ± 13.2 years, 13,525 men) who underwent annual physical checkups between 2010 and 2023. Cross-sectional analysis of first-visit data revealed significantly higher Na/K ratios among individuals with hypertension compared to normotensive individuals (5.05 ± 2.85 vs. 4.39 ± 2.47, p < 0.001). Multiple regression analysis showed a significant association between the Na/K ratio and systolic BP. After excluding participants with hypertension, 12,483 normotensive individuals (48.7 ± 11.9 years; 7087 men) were followed for a median of 1788 days. During the follow-up period, 4056 participants developed hypertension. Kaplan–Meier analysis indicated an increased risk of hypertension across baseline Na/K ratio quartiles (log-rank, p < 0.001). Univariate Cox regression analysis identified the Na/K ratio as a significant predictor of incident hypertension, with hazard ratios increasing across quartiles. Multivariate analysis confirmed the association (hazard ratio [HR] = 1.408, 95% confidence interval [CI]; 1.225–1.619), although the Na/K ratio was not independently associated with hypertension onset after additional adjustment for baseline systolic BP. These findings suggest that the urinary Na/K ratio is significantly associated with the risk of hypertension in the general population. Therefore, dietary interventions that lower the Na/K ratio may prevent the development of hypertension.