ArticleHypertension (Dallas, Tex. : 1979)2018
Relation of Dietary Sodium (Salt) to Blood Pressure and Its Possible Modulation by Other Dietary Factors: The INTERMAP Study.
2 registry-linked trialsOpen access · bronzeAbstract read
In one paragraph
Article in Hypertension (Dallas, Tex. : 1979), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 59 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 1 pooled it
9.2field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
INTERMAP: International Population Study on Macronutrients and BP
Education to Decrease in Sodium Intake in University Students Evaluated With 24 Hour Urinary Sodium Excretion: Randomized Controlled Trial
Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 115 citations in OpenAlex.
- Association between the Urinary Sodium to Potassium Ratio and Blood Pressure in Adults: A Systematic Review and Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2021Pooled it
- Validation of preferred salt concentration in soup based on a randomized blinded experiment in multiple regions in Japan-influence of umami (L-glutamate) on saltiness and palatability of low-salt solutions.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Trial
- A pilot study on efficacy and safety of a new salt substitute with very low sodium among hypertension patients on regular treatment.Medicine · 2020Trial
- Regional effect of population-based programs promoting salt reduction and potassium intake in Hokkaido: a post hoc analysis of the PoSPIP.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Response to: Comment on: Association of subjective and objective physical activity with home hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Sodium Retention and Distribution in Growing and Adult Rodents Fed High and Low Salt Diets.Nutrients · 2026Article
- How Does Dietary Potassium Influence BP?Journal of the American Society of Nephrology : JASN · 2026Review
- Current hypertension epidemiology and contemporary approaches using the "Real-World Evidence Cycle" framework.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Review
- Article
- Association between urinary sodium-to-potassium ratio and BNP in a general population without antihypertensive treatment and cardiovascular diseases: the Ohasama study.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- 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
- Ethnic differences in knowledge, attitudes, and practices related to dietary salt intake and association with hypertension in Malaysia: a multi-centre cross-sectional study.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Role of dietary potassium and salt substitution in the prevention and management of hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Review
- Practical use and target value of urine sodium-to-potassium ratio in assessment of hypertension risk for Japanese: Consensus Statement by the Japanese Society of Hypertension Working Group on Urine Sodium-to-Potassium Ratio.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Article
- Impact of a nudge-based food environment intervention in a hospital convenience store on staff's food intake and Na/K.BMC nutrition · 2024Article
- Effects of salt intake reduction by urinary sodium to potassium ratio self-monitoring method.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Burden of diseases due to high systolic blood pressure in the Middle East and North Africa region from 1990 to 2019.Scientific reports · 2024Article
- Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 4 countries.
Jeremiah StamlerFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.). j-stamler@northwestern.edu q.chan@imperial.ac.uk.
Queenie ChanFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Martha L DaviglusFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Alan R DyerFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Linda Van HornFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Daniel B GarsideFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Katsuyuki MiuraFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Yangfeng WuFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Hirotsugu UeshimaFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Liancheng ZhaoFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
Paul ElliottFrom the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (J.S., M.L.D., A.R.D., L.V.H.); Institute for Minority Health Research, University of Illinois, Chicago (M.L.D., D.B.G.); Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom (Q.C., P.E.); Department of Public Health, Shiga University of Medical Science, Otsu, Japan (K.M., H.U.); the George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, China (L.Z.).
INTERMAP Research Group
University of Illinois Urbana-Champaign · USShiga University of Medical Science · JPGeorge Institute for Global Health · CNImperial College London · GBPeking University · CNUniversity of Illinois Chicago · US
Funding
INTL POPULATION STUDY ON MACRONUTRIENTS AND BP INTERMAPR01HL050490 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI DAVIGLUS, MARTHA L, ELLIOTT, PAUL · 1995 to 2013
$7.3MMetabolomics-Measured Urinary Metabolites, Diet & BP, 17 Population Samples: INTER01HL084228 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI DAVIGLUS, MARTHA L, ELLIOTT, PAUL · 2007 to 2014
$4.2MMetabolic Pathways Underlying the Contrasting Sodium-BP and DASH/OmniHeart-BP RelationshipsR01HL135486 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI DAVIGLUS, MARTHA L, ELLIOTT, PAUL · 2017 to 2020
$2.6MINTERSALT: NEXT PHASE-FOCUS ON PROTEIN NA, K, &BPR01HL033387 · NHLBI · NORTHWESTERN UNIVERSITY · PI STAMLER, JEREMIAH · 1985 to 1995
–Medical Research Council MR/L01341X/1Medical Research Council MR/L01632X/1NHLBI NIH HHS R01 HL033387NHLBI NIH HHS R01 HL050490NHLBI NIH HHS R01 HL084228NHLBI NIH HHS R01 HL135486
Abstract
Available data indicate that dietary sodium (as salt) relates directly to blood pressure (BP). Most of these findings are from studies lacking dietary data; hence, it is unclear whether this sodium-BP relationship is modulated by other dietary factors. With control for multiple nondietary factors, but not body mass index, there were direct relations to BP of 24-hour urinary sodium excretion and the urinary sodium/potassium ratio among 4680 men and women 40 to 59 years of age (17 population samples in China, Japan, United Kingdom, and United States) in the INTERMAP (International Study on Macro/Micronutrients and Blood Pressure), and among its 2195 American participants, for example, 2 SD higher 24-hour urinary sodium excretion (118.7 mmol) associated with systolic BP 3.7 mm Hg higher. These sodium-BP relations persisted with control for 13 macronutrients, 12 vitamins, 7 minerals, and 18 amino acids, for both sex, older and younger, blacks, Hispanics, whites, and socioeconomic strata. With control for body mass index, sodium-BP-but not sodium/potassium-BP-relations were attenuated. Normal weight and obese participants manifested significant positive relations to BP of urinary sodium; relations were weaker for overweight people. At lower but not higher levels of 24-hour sodium excretion, potassium intake blunted the sodium-BP relation. The adverse association of dietary sodium with BP is minimally attenuated by other dietary constituents; these findings underscore the importance of reducing salt intake for the prevention and control of prehypertension and hypertension. CLINICAL
trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT00005271.
Indexed as
Blood PressureDietary Approaches To Stop HypertensionHypertensionNutrientsAdultBlood Pressure DeterminationChinaData Interpretation, StatisticalFeeding BehaviorFemaleHumansJapanMaleMiddle AgedPotassium, DietaryRenal EliminationNutrientsPotassium, DietarySodium, Dietaryblood pressurediethypertensionpotassiumsodium
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Registered trials
NCT00005271ClinicalTrials.gov
NCT04894344ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.