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. 1990 Apr 7;300(6729):899–902. doi: 10.1136/bmj.300.6729.899

Sodium and potassium intake and blood pressure change in childhood.

J M Geleijnse 1, D E Grobbee 1, A Hofman 1
PMCID: PMC1662662  PMID: 2337712

Abstract

OBJECTIVE--To assess the association between sodium and potassium intake and the rise in blood pressure in childhood. DESIGN--Longitudinal study of a cohort of children with annual measurements during an average follow up period of seven years. SETTING--Epidemiological survey of the population of a suburban town in western Netherlands. SUBJECTS--Cohort of 233 children aged 5-17 drawn at random from participants in the population survey. MAIN OUTCOME MEASURES--At least six annual timed overnight urine samples were obtained. The mean 24 hour sodium and potassium excretion during the follow up period was estimated for each participant and the sodium to potassium ratio calculated. Individual slopes of blood pressure over time were calculated by linear regression analysis. RESULTS--No significant association was observed between sodium excretion and the change in blood pressure over time. The mean systolic blood pressure slopes, however, were lower when potassium intake was higher (coefficient of linear regression -0.045 mm Hg/year/mmol; 95% confidence interval -0.069 to -0.020), and the change in systolic pressure was greater when the urinary sodium to potassium ratio was higher (0.356 mm Hg/year/unit; 95% confidence interval 0.069 to 0.642). In relation to potassium this was interpreted as a rise in blood pressure that was on average 1.0 mm Hg (95% confidence interval -1.65 to -0.35) lower in children in the upper part of the distribution of intake compared with those in the lower part. The mean yearly rise in systolic blood pressure for the group as a whole was 1.95 mm Hg. Urinary electrolyte excretion was not associated with diastolic blood pressure. CONCLUSION--Dietary potassium and the dietary sodium to potassium ratio are related to the rise in blood pressure in childhood and may be important in the early pathogenesis of primary hypertension.

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Selected References

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  1. Akinkugbe O. O., Akinkugbe F. M., Ayeni O., Solomon H., French K., Minear R. Biracial study of arterial pressures in the first and second decades of life. Br Med J. 1977 Apr 30;1(6069):1132–1134. doi: 10.1136/bmj.1.6069.1132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cooper R., Liu K., Trevisan M., Miller W., Stamler J. Urinary sodium excretion and blood pressure in children: absence of a reproducible association. Hypertension. 1983 Jan-Feb;5(1):135–139. doi: 10.1161/01.hyp.5.1.135. [DOI] [PubMed] [Google Scholar]
  3. Frank G. C., Berenson G. S., Webber L. S. Dietary studies and the relationship of diet to cardiovascular disease risk factor variables in 10-year-old children--The Bogalusa Heart Study. Am J Clin Nutr. 1978 Feb;31(2):328–340. doi: 10.1093/ajcn/31.2.328. [DOI] [PubMed] [Google Scholar]
  4. Hofman A., Hazebroek A., Valkenburg H. A. A randomized trial of sodium intake and blood pressure in newborn infants. JAMA. 1983 Jul 15;250(3):370–373. [PubMed] [Google Scholar]
  5. Hofman A., Valkenburg H. A. Determinants of change in blood pressure during childhood. Am J Epidemiol. 1983 Jun;117(6):735–743. doi: 10.1093/oxfordjournals.aje.a113607. [DOI] [PubMed] [Google Scholar]
  6. Hofman A., Valkenburg H. A., Maas J., Groustra F. N. The natural history of blood pressure in childhood. Int J Epidemiol. 1985 Mar;14(1):91–96. doi: 10.1093/ije/14.1.91. [DOI] [PubMed] [Google Scholar]
  7. Khaw K. T., Barrett-Connor E. The association between blood pressure, age, and dietary sodium and potassium: a population study. Circulation. 1988 Jan;77(1):53–61. doi: 10.1161/01.cir.77.1.53. [DOI] [PubMed] [Google Scholar]
  8. Knuiman J. T., van Poppel G., Burema J., van der Heijden L., Hautvast J. G. Multiple overnight urine collections may be used for estimating the excretion of electrolytes and creatinine. Clin Chem. 1988 Jan;34(1):135–138. [PubMed] [Google Scholar]
  9. Labarthe D. R., Morris D. L., Freyer B. S. Blood pressure during growth and development. Ann Clin Res. 1984;16 (Suppl 43):35–43. [PubMed] [Google Scholar]
  10. Lever A. F., Beretta-Piccoli C., Brown J. J., Davies D. L., Fraser R., Robertson J. I. Sodium and potassium in essential hypertension. Br Med J (Clin Res Ed) 1981 Aug 15;283(6289):463–468. doi: 10.1136/bmj.283.6289.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Liu K., Cooper R., Soltero I., Stamler J. Variability in 24-hour urine sodium excretion in children. Hypertension. 1979 Nov-Dec;1(6):631–636. doi: 10.1161/01.hyp.1.6.631. [DOI] [PubMed] [Google Scholar]
  12. Liu K., Dyer A. R., Cooper R. S., Stamler R., Stamler J. Can overnight urine replace 24-hour urine collection to asses salt intake? Hypertension. 1979 Sep-Oct;1(5):529–536. doi: 10.1161/01.hyp.1.5.529. [DOI] [PubMed] [Google Scholar]
  13. Simpson F. O. Salt and hypertension: current data, attitudes, and policies. J Cardiovasc Pharmacol. 1984;6 (Suppl 1):S4–S9. [PubMed] [Google Scholar]
  14. Szklo M. Epidemiologic patterns of blood pressure in children. Epidemiol Rev. 1979;1:143–169. doi: 10.1093/oxfordjournals.epirev.a036207. [DOI] [PubMed] [Google Scholar]
  15. Treasure J., Ploth D. Role of dietary potassium in the treatment of hypertension. Hypertension. 1983 Nov-Dec;5(6):864–872. doi: 10.1161/01.hyp.5.6.864. [DOI] [PubMed] [Google Scholar]

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