S-54-3: prediction and prevention of the onset of hypertension from the viewpoint of estimated 24-hour salt excretion and physical fitness test

Objective: Both dietary salt and physical activity contribute substantially to development and progression of blood pressure elevation. Earlier detection of blood pressure change by daily simple procedures are effective for health promotion less expensively. We performed both longitudinal and cross-sectional observations for the subjects with annual comprehensive health checkup to test relationships among daily salt intake, physical activity, and blood pressure elevation. Methods: We performed following three observations. A)Body weights, interviewed salt intakes (i-NaCl), and estimated salt intakes (e-NaCl) for single spot urine (Tanaka formula) were measured and compared to blood pressure change monthly for one year in total 17,794 participants. B) To test significance of shared e-NaCl information to health promotions, we shared e-NaCl to total 98,908 participants individually and, subsequently, annual-mean e-NaCl was compared for 5 years. C) To test significance of physical activity for blood pressure elevations, we performed 5-year follow up study for total 22,972 participants to examine the onset of hypertension and physical activity as followings; duration of single-leg balance with eyes closed (sec), grip strength (kg), forward bending (cm), whole body reaction time (msec), vertical jump distance (cm), and supine leg-up (sec), respectively. Results: A) Only e-NaCl was found to have a strong correlation with the monthly mean systolic blood pressure as shown in a figure. B) By sharing e-NaCl information with participants, annual mean of e-NaCl decreased significantly from 9.22 g/day (male) and 8.79 g/day (female) in 2012 to 9.03 g/day (male) and 8.63 g/day (female) in 2017. C) Even when adjusted for gender, age, BMI, systolic and diastolic blood pressure of first year, single-leg balance with eyes closed and forward bending were significantly associated with the onset of hypertension. Conclusion: Since e-NaCl is affected by salt excretion due to sweating, it was presumed that the amount of salt to be excreted in urine correlated well with seasonal changes in blood pressure. In addition, e-NaCl measurement is a good tool that can be used for health guidance to examinees for their life style promotion. It was found that flexibility and a sense of equilibrium are related to the onset of blood pressure.