ArticleBMJ open2016
Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 3 of them syntheses that pooled it.
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Who cites it
79 citing papers in PubMed, 3 syntheses or guidelines pooled it, 162 citations in OpenAlex.
- Dietary salt intake and cardiovascular outcomes: an umbrella review of meta-analyses and dose-response evidence.Annals of medicine · 2025Pooled it
- Japanese-Style Diet and Cardiovascular Disease Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.Nutrients · 2022Pooled it
- More evidence that salt increases blood pressure and risk of kidney disease from the Science of Salt: A regularly updated systematic review of salt and health outcomes (April-July 2016).Journal of clinical hypertension (Greenwich, Conn.) · 2017Pooled it
- Trial
- Effectiveness of a Self-monitoring Device for Urinary Sodium-to-Potassium Ratio on Dietary Improvement in Free-Living Adults: a Randomized Controlled Trial.Journal of epidemiology · 2018Trial
- Trial
- Sodium reduction and salt substitutes: impact on blood pressure and recurrent stroke.Current opinion in cardiology · 2026Review
- Ultra-Processed Food Consumption Is Associated With an Unfavorable Nutrient Profile and a Higher Likelihood of Hypertension Among Women Living in Brazilian Favelas.Journal of lipid and atherosclerosis · 2026Article
- The Japanese Society of Hypertension Guidelines for blood pressure control using digital technologies.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Adherence to the Mediterranean Diet and Dietary Potassium Intake: A Narrative Review of Epidemiological Evidence.Nutrients · 2026Review
- Lack of knowledge about the hypotensive effects of potassium and dairy: current hypertension-related knowledge and results of a knowledge intervention in Japanese workers.Environmental and occupational health practice · 2026Article
- Neutrophil stalling does not mediate the increase in tau phosphorylation and the cognitive impairment associated with high salt diet.Cardiovascular research · 2025Article
- The association between sodium index and the risk of obesity in Korean and Chinese university students: a cross-sectional study.Korean journal of community nutrition · 2025Article
- Factors related to high sodium intake based on 24-hour urinary sodium excretion in population aged 50 years and older.Scientific reports · 2025Article
- Review
- Understanding Renal Tubular Function: Key Mechanisms, Clinical Relevance, and Comprehensive Urine Assessment.Pathophysiology : the official journal of the International Society for Pathophysiology · 2025Review
- Metabolic risk factors, blood pressure and atherogenic indices of cardiovascular disease across different quartiles of dietary sodium to potassium ratio among young semi-professional athletes with overweight or obesity.BMC sports science, medicine & rehabilitation · 2025Article
- Temporal trends in cardiovascular disease risk factors attributed burden in Iran, 1990-2021.Scientific reports · 2025Article
- Dietary salt, vascular dysfunction, and cognitive impairment.Cardiovascular research · 2025Review
- Does casual urine Na/K ratio predict 24 h urine Na/K ratio in treated hypertensive patients? Comparison between casual urine voided in the morning vs. 24 h urine collected on the previous day.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
19 more citing papers are in PubMed but not listed here.
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Authors and funding
17 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the impact of dietary sodium and potassium (Na-K) ratio on mortality from total and subtypes of stroke, cardiovascular disease (CVD) and all causes, using 24-year follow-up data of a representative sample of the Japanese population.
settingProspective cohort study.
participantsIn the 1980 National Cardiovascular Survey, participants were followed for 24 years (NIPPON DATA80, National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged). Men and women aged 30-79 years without hypertensive treatment, history of stroke or acute myocardial infarction (n=8283) were divided into quintiles according to dietary Na-K ratio assessed by a 3-day weighing dietary record at baseline. Age-adjusted and multivariable-adjusted HRs were calculated using the Mantel-Haenszel method and Cox proportional hazards model. PRIMARY OUTCOME MEASURES: Mortality from total and subtypes of stroke, CVD and all causes.
resultsA total of 1938 deaths from all causes were observed over 176 926 person-years. Na-K ratio was significantly and non-linearly related to mortality from all stroke (p=0.002), CVD (p=0.005) and total mortality (p=0.001). For stroke subtypes, mortality from haemorrhagic stroke was positively related to Na-K ratio (p=0.024). Similar relationships were observed for men and women. The observed relationships remained significant after adjustment for other risk factors. Quadratic non-linear multivariable-adjusted HRs (95% CI) in the highest quintile versus the lowest quintile of Na-K ratio were 1.42 (1.07 to 1.90) for ischaemic stroke, 1.57 (1.05 to 2.34) for haemorrhagic stroke, 1.43 (1.17 to 1.76) for all stroke, 1.39 (1.20 to 1.61) for CVD and 1.16 (1.06 to 1.27) for all-cause mortality.
conclusionsDietary Na-K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population.
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