Association Between Hypertension Prevalence and Dietary Sodium-Potassium Ratio: A Case Study of CDC Database

Abstract

Hypertension remains one of the most prevalent chronic diseases in modern society and a leading cause of cardiovascular mortality. According to data from the Centers for Disease Control and Prevention (CDC), nearly half of American adults have hypertension, and in 2023, hypertension was a primary contributing factor in 664,470 deaths in the United States. While previous research has established the individual impacts of sodium and potassium intake on blood pressure, there is a lack of independent association testing for the sodium-potassium (Na/K) ratio as a combined dietary metric. Furthermore, following the COVID-19 pandemic,residents' dietary patterns have undergone significant changes, altering the metabolic baseline risk for hypertension. This study aims to verify the impact of daily dietary Na/K ratio on hypertension risk and to construct a multi-factor prediction model. Based on the NHANES cross-sectional database, this study enrolled 2,586 participants and employed a comprehensive analytical approach integrating descriptive analysis, K-means clustering, multivariable-adjusted logistic models, restricted cubic spline (RCS) techniques, and LASSO regularization for variable selection. Model performance was assessed using ROC curves and Nomograms, with stratified analyses examining the Na/K ratio-hypertension association. The dietary Na/K ratio emerged as an independent risk marker for hypertension, with significant pathogenic effects observed exclusively in older adults. Moreover, the Na/K ratio exhibited synergistic effects with central adiposity in elevating hypertension risk. These findings support the development of age-stratified, Na/K ratio-focused personalized dietary interventions for hypertension prevention.