Associations between sodium, potassium, and blood pressure: Results from the Hispanic Community Health Study/Study of Latinos, a prospective cohort study

Background While the subject of numerous studies, the associations between dietary sodium, potassium and the ratio of dietary sodium -to- potassium with blood pressure are not clear-cut. In addition, there is a paucity of research on these relationships in prospective cohort studies with representation from diverse Hispanic/Latino adults. Objective To evaluate the associations between dietary intake of sodium, potassium and the ratio of dietary sodium -to- potassium and blood pressure in a diverse sample of Hispanics living in the United States. Methods This analysis included 11,429 Hispanic/Latino participants of the prospective cohort Hispanic Community Health Study/ Study of Latinos recruited between 2008 and 2011 in visit 1 who participated in a follow-up visit in 2014-2017. Dietary sodium and potassium intakes were averaged from two interviewer-administered 24-hour diet recalls collected at visit 1. At both visits, blood pressure was measured three times in a seated position and averaged. We assessed the relationship between dietary sodium, potassium, and the sodium -to- potassium ratio with changes in systolic and diastolic blood pressure using survey weighted multivariable adjusted regression models. Results At visit 1, the mean age was 41 years, and mean sodium intake was 3,203 mg/day. Each 500 mg/day sodium increment in intake was associated with an increase in systolic blood pressure (β=0.35 (mmHg), 95% CI = 0.06, 0.63) and diastolic blood pressure (β=0.45 (mmHg), 95% CI = 0.08, 0.82). Dietary potassium and the molar ratio of dietary sodium -to- potassium were not associated with changes in systolic or diastolic blood pressure. Conclusions Among a large sample of diverse US Hispanics/Latino adults, higher sodium intake was associated with small increases in systolic blood pressure over six years. This research underscores the importance of dietary sodium reduction in maintaining lower blood pressure.