Journal of Hypertension: Open Access

Urinary Sodium and Potassium Excretion in Bangladeshi Urban and Rural Adults: Results from a Population-Based Survey with 24 hr Urine Collections

Abstract

Jubaida Akhtar*, Mohammad A Al-Mamun, Mohammad NN Sayem, Mohammad J Ahmed, Mahfuzur R Bhuiyan, Shamim Jubayer, Abdul Alim, Mohammad R Amin, Md R Karim, Megan E Henry, Matti Marklund, Laura Cobb, Dinesh Neupane, Lawrence J Appel and Sohel R Choudhury

Objectives: The high burden of blood pressure-related cardiovascular diseases in Bangladesh is potentially linked to excessive dietary sodium and insufficient potassium intake. This study assessed the dietary salt and potassium intake among rural and urban adults in Bangladesh through urinary sodium and potassium excretion. Methods: We conducted a cross-sectional study between December 2017 and June 2018, including participants aged 30-59 years from three urban and three rural sites. Data included urinary excretion of sodium and potassium estimated from one 24-hour urine collection and blood pressure measurements. Results: Among the 840 enrolled participants, complete data was available in 509 individuals. Mean age was 43.0 (SD ± 7.9) years; 20.9% had hypertension, 50.9% were women and 50.9% resided in urban areas. Mean systolic and diastolic blood pressure were 118.6 (SD ± 16.6) mmHg and 76.3 (SD ± 11.3) mmHg, respectively. Overall, mean urinary sodium excretion was 3.9 gm/day (95% CI=3.8 to 4.0), corresponding to a mean salt intake of 9.7 g/day (95% CI=9.4-10.1). Mean urinary potassium excretion was 1.4 g/day (95% CI=1.3-1.4), corresponding to an estimated mean dietary potassium intake of 2.0 g/day. Men and urban residents had slightly higher sodium and potassium excretion than women and rural residents. Conclusion: In Bangladesh, salt intake exceeded WHO's recommended <5 g/day limit, while potassium intake was substantially lower than the recommended intake of >3.5 g/day for adults. Promoting low-sodium and potassium-rich diets through nationwide campaigns and policies, including advocating for accessible low-sodium and potassium-enriched salt substitutes, is recommended to mitigate cardiovascular disease risks.