Association between the Urinary Sodium to Potassium Ratio and Blood Pressure in Adults: A Systematic Review and Meta-Analysis

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#adult #blood-pressure #diet #humans #hypertension

Association between the Urinary Sodium to Potassium Ratio and Blood Pressure in Adults: A Systematic Review and Meta-Analysis

Ndanuko et al., 2021 | Adv Nutr | Meta Analysis

Citation

Ndanuko Rhoda N, Ibrahim Rukayat, ... Charlton Karen E. Association between the Urinary Sodium to Potassium Ratio and Blood Pressure in Adults: A Systematic Review and Meta-Analysis. Adv Nutr. 2021-Oct-01;12(5):1751-1767. doi:10.1093/advances/nmab036

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.

Key Findings

Dietary strategies to achieve an increase in potassium while at the same time lowering sodium would be beneficial in lowering BP.

Outcomes Measured

  • blood pressure
  • systolic blood pressure
  • diastolic blood pressure

Population

Field Value
Population See abstract
Sample Size 5
Age Range See abstract
Condition blood pressure

MeSH Terms

  • Adult
  • Blood Pressure
  • Diet
  • Humans
  • Hypertension
  • Potassium
  • Randomized Controlled Trials as Topic
  • Sodium

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09