SynthesisAdvances in nutrition (Bethesda, Md.)2021
Association between the Urinary Sodium to Potassium Ratio and Blood Pressure in Adults: A Systematic Review and Meta-Analysis.
Synthesis in Advances in nutrition (Bethesda, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Effect of exercise training on the renin-angiotensin-aldosterone system: a meta-analysis.Journal of human hypertension · 2024Pooled it
- The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies.Advances in nutrition (Bethesda, Md.) · 2024Pooled it
- Sodium reduction is the key ingredient in dietary treatment of hypertension - a randomized controlled trial on sodium, potassium and nitrate.Journal of human hypertension · 2026Trial
- Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences.Cells · 2026Review
- Impact of Socioeconomic Factors and Lifestyle on Salt and Potassium Intake and Sodium-to-Potassium Ratio: EH-UH 2 Study.Nutrients · 2026Article
- Elevated NaInternational journal of molecular sciences · 2026Article
- Elevated NabioRxiv : the preprint server for biology · 2025Article
- A comparative analysis on the latest international and local guidelines for the management of hypertension.Singapore medical journal · 2025Article
- Dairy consumption has a partial inverse association with systolic blood pressure and hypertension in populations with high salt and low dairy diets: cross-sectional data analysis from the Iwaki Health Promotion Project.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Age-period-cohort analysis of dietary sodium, potassium, and sodium-to-potassium ratio in Korea.Epidemiology and health · 2025Article
- Japanese Diet Indices and Nutrient Density in US Adults: A Cross-Sectional Analysis with NHANES Data.Nutrients · 2024Article
- Sodium Intake and Sodium to Potassium Ratio among New York City Adults in the 2018 Heart Follow-Up Study.Current developments in nutrition · 2024Article
- Using Genetics to Inform Interventions Related to Sodium and Potassium in Hypertension.Circulation · 2024Observational
- Spot urinary sodium-to-potassium ratio is associated with blood pressure levels in healthy adolescents: the Wakayama Study.Journal of human hypertension · 2024Article
- Association between sodium-to-potassium ratio in spot urine and hospitalization due to heart failure in high-risk Japanese patients.International journal of cardiology. Heart & vasculature · 2024Article
- Association between spot urinary sodium-to-potassium ratio and blood pressure among Chinese adults aged 18-69 years: the SMASH study.Frontiers in nutrition · 2024Article
- Association of healthy lifestyle factors with the risk of hypertension, dyslipidemia, and their comorbidity in Korea: results from the Korea National Health and Nutrition Examination Survey 2019-2021.Epidemiology and health · 2024Article
- Dissociation of sodium-chloride cotransporter expression and blood pressure during chronic high dietary potassium supplementation.JCI insight · 2023Article
- Development of a short-form Chinese health literacy scale for low salt consumption (CHLSalt-22) and its validation among hypertensive patients.BMC nutrition · 2022Article
- Potassium homeostasis: sensors, mediators, and targets.Pflugers Archiv : European journal of physiology · 2022Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
While sodium and potassium are individually important for blood pressure (BP) regulation, the relative contribution of sodium to potassium intake has not been sufficiently investigated. This study aimed to evaluate the association between urinary sodium to potassium ratio (UNa: K) and systolic and diastolic BP in adults. A systematic review (PROSPERO; CRD42016035296) was conducted and was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Three scientific databases (MEDLINE, Scopus, Web of Science) were searched to March 2020 while reference lists of included articles were further hand-searched. Randomized controlled trials (RCT), cohort and cross-sectional studies that assessed 24-h urinary excretion in adults were included. Data from eligible studies were extracted and summarized. Random effects meta-analysis was conducted on RCT data to assess standardized mean differences (SMD) in systolic and diastolic BP according to 24-h UNa: K. Thirty-nine studies were included. Meta-analysis of 5 RCTs found a lower UNa: K ratio to be associated with a significantly greater reduction in systolic and diastolic BP compared with a higher UNa: K ratio [SMD: -1.09 (95% CI: -1.91, -0.28) mmHg and -1.42 (95% CI: -2.24, -0.59) mmHg, respectively]. Heterogeneity between RCTs was observed in systolic and diastolic BP (I2 = 97%, P < 0.0001 and I2 = 98%, P < 0.0001, respectively). The current body of evidence demonstrates that a lower 24-h UNa: K ratio is associated with lower BP in adults. Dietary strategies to achieve an increase in potassium while at the same time lowering sodium would be beneficial in lowering BP.
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Registered trials
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.