ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1522607
Cross-sectional Study on the Association between 24-hour Urinary Potassium Excretion and the Risk of H-type Hypertension and Non-H-type Hypertension in Chinese Adults
Provisionally accepted- Zhejiang Provincial Center for Disease Control and Prevention, Hang zhou, China
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Objective: Reports on urinary potassium excretion and H-type hypertension remains rare. We aimed to describe the relationship between 24-hour (h) urinary potassium excretion and the risk of H-type hypertension and non-H-type hypertension, thus to guide personal and public health campaigns including dietary recommendations to lower H-type hypertension and non-H-type hypertension in China. Methods: In 2020 in Zhejiang, China, a cross-sectional survey was conducted by using a stratified multistage random sampling strategy, with participants aged 21 to 72 years. Standardized questionnaires, physical examinations and laboratory measurements were carried out among them, as well as survey on knowledge, attitudes, and behavior (KAB) correlated with salt and hypertension. 24-h urine specimens were collected for sodium and potassium excretion measurement. Subjects were divided into three groups, normal blood pressure, non-H-type hypertension and H-type hypertension, according to their blood pressure, self-reported history of hypertension and blood Homocysteine (Hcy) levels. Results: 1141 participants with complete information were obtained with the median age of 53 years, 46.0% were males, 41.7% were hypertension, among which 80.5% were H-type hypertension. The median Hcy and 24-h urinary potassium were 11.7μmol/L and 40.83 mmol/24h, respectively. After controlling for confounding factors, logistic regression analysis displayed that for every 1 mmol/L increase in 24-h urinary potassium excretion, the risk of H-type hypertension and non-H-type hypertension decreased by 1.4% (OR=0.986, 95% CI: 0.978-0.995, P=0.002) and 1.7% (OR=0.983, 95% CI: 0.968-0.998, P=0.025), respectively. Restricted cubic spline (RCS) curves showed that with the increase of 24-h urinary potassium excretion, the risk of both H-type hypertension (P= 0.008) and non-H-type hypertension (P=0.027) decreased, while there were no nonlinear dose-response relationships between 24-h urinary potassium excretion with both H-type hypertension (P for non-linearity = 0.881) and non-H-type hypertension (P for non-linearity = 0.101). Participants’ level of KAB in H-type hypertension group presented a lower percentage (86.2%) knowledge of the risk factors of hypertension, a highest percentage (12.5%) of self-assessment of excessive salt intake, but a lowest percentage (23.0%) of taking initiative to reduce salt intake. Conclusion: 24-h urinary potassium excretion was negatively associated with the risk of both H-type hypertension and non-H-type hypertension.
Keywords: 24-h urinary potassium excretion, H-type hypertension, non-H-type hypertension;, Homocysteine, Diet, knowledge attitude and behavior
Received: 09 Nov 2024; Accepted: 02 Jun 2025.
Copyright: © 2025 He, Du, Chen, Wang, Fang and Zhong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qingfang He, Zhejiang Provincial Center for Disease Control and Prevention, Hang zhou, China
Jieming Zhong, Zhejiang Provincial Center for Disease Control and Prevention, Hang zhou, China
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