Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group.

doi:10.1136/bmj.297.6644.319

BMJ 1988;297:319-328 (30 July), doi:10.1136/bmj.297.6644.319

Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group.

The relations between 24 hour urinary electrolyte excretionand blood pressure were studied in 10,079 men and women aged20-59 sampled from 52 centres around the world based on a highlystandardised protocol with central training of observers, acentral laboratory, and extensive quality control. Relationsbetween electrolyte excretion and blood pressure were studiedin individual subjects within each centre and the results ofthese regression analyses pooled for all 52 centres. Relationsbetween population median electrolyte values and populationblood pressure values were also analysed across the 52 centres.Sodium excretion ranged from 0.2 mmol/24 h (Yanomamo Indians,Brazil) to 242 mmol/24 h (north China). In individual subjects(within centres) it was significantly related to blood pressure.Four centres found very low sodium excretion, low blood pressure,and little or no upward slope of blood pressure with age. Acrossthe other 48 centres sodium was significantly related to theslope of blood pressure with age but not to median blood pressureor prevalence of high blood pressure. Potassium excretion wasnegatively correlated with blood pressure in individual subjectsafter adjustment for confounding variables. Across centres therewas no consistent association. The relation of sodium to potassiumratio to blood pressure followed a pattern similar to that ofsodium. Body mass index and heavy alcohol intake had strong,significant independent relations with blood pressure in individualsubjects.

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