
Urinary Sodium and Potassium Excretion in Bangladeshi Adults: Results from a Population-Based Survey with 24-Hour Urine Collections
References
- Mills TK, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–237. DOI: 10.1038/s41581-019-0244-2
- Wang K, Jin Y, Wang M, Liu J, Bu X, Mu J, et al. Global cardiovascular diseases burden attributable to high sodium intake from 1990 to 2019. J Clin Hypertens (Greenwich). 2023;25(9):868–879. DOI: 10.1111/jch.14717
- Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388:1459–1544. DOI: 10.1016/S0140-6736(16)31012-1
- Bangladesh College for Physicians and Surgeons (BCPS). FACTSHEET 2022, Bangladesh. National Non-communicable Disease Risk Factor Survey in Bangladesh according to WHO STEPS approach. Available at:
https://app.dghs.gov.bd/pmr/uploads/publication/861604456_1717391812.pdf . - Mondal MBA, Hasan ATMH, Khan N, Mohammad QD. Prevalence and risk factors of stroke in Bangladesh: A nationwide population-based survey. eNeurologicalSci. 2022;28:
100414 . DOI: 10.1016/j.ensci.2022.100414 - World Health Organization. Noncommunicable Diseases (NCD): Bangladesh Country Profile 2018. Available at:
https://www.who.int/nmh/countries/bgd_en.pdf . - Shafieyan Z, Qorbani M, Mehr BR, Mahboubi M, Rezapour A, Safari O, et al. Association between lifestyle and hypertension in patients referred to health care centers of Ilam city in 2014. Global Journal of Health Science. 2016;8(6):161–167. DOI: 10.5539/gjhs.v8n6p161
- Brown JI, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: Implications for public health. Int J Epidemiol. 2009;38(3):791–813. DOI: 10.1093/ije/dyp139
- Intersalt Cooperative Research Group. Intersalt: An international study of electrolyte excretion and blood pressure. Results for 24 hr urinary sodium and potassium excretion. BMJ. 1988;297(6644):319–328. DOI: 10.1136/bmj.297.6644.319
- Beaglehole R, Bonita R, Horton R, Ezzati M, Bhala N, Amuyunzu-Nyamongo M, et al. Measuring progress on NCDs: One goal and five targets. The Lancet. 2012;380(9850):1283–1285. DOI: 10.1016/S0140-6736(12)61692-4
- World Health Organization. WHO global report on sodium intake reduction. Geneva (SW); 2023. Available at:
https://iris.who.int/bitstream/handle/10665/366393/9789240069985-eng.pdf?sequence=1 . - World Health Organization. Guideline: Sodium intake for adults and children. Geneva (SW); 2012. Available at:
https://www.who.int/publications/i/item/9789241504836 . - Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021–3104. DOI: 10.1093/eurheartj/ehy339
- Appel JL, Frohlich ED, Hall JE, Pearson TA, Sacco RL, Seals DR, et al. The importance of population-wide sodium reduction as a means to prevent cardiovascular disease and stroke: a call to action from the American Heart Association. Circulation. 2011;123:1138–1143. DOI: 10.1161/CIR.0b013e31820d0793
- World Health Organization. Guideline: Potassium intake for adults and children. Geneva (SW); 2012. Available at:
https://www.who.int/publications/i/item/9789241504829 . - Grimes CA, Baxter JR, Campbell KJ, Riddell LJ, Rigo M, Liem DG, et al. Cross-sectional Study of 24-hr urinary electrolyte excretion and associated health outcomes in a convenience sample of Australian primary schoolchildren: The Salt and Other Nutrients in Children (SONIC) Study Protocol. JMIR Res. Protoc. 2015;4(1):
e7 . DOI: 10.2196/resprot.3994 - World Health Organization. WHO SEARO Salt Reduction Toolkit. Measurement of Population Salt Intake. Geneva (SW). Available at:
https://cdn.who.int/media/docs/default-source/searo/healthy-diets/salt-reduction/measurement-of-population-salt-intake.pdf?sfvrsn=b8e360f4 . - Allsopp AJ, Sutherland R, Wood P, Wootton SA. The effect of sodium balance on sweat sodium secretion and plasma aldosterone concentration. Eur J Appl Physiol Occup Physiol. 1998;78(6):516–521. PMID: 9840406. DOI: 10.1007/s004210050454
- Turban S, Miller ER, Ange B, Appel LJ. Racial differences in urinary potassium excretion. JASN. 2008;19(7):1396–1402. DOI: 10.1681/ASN.2007101142
- World Health Organization. Standard STEPS instrument (Question-by-question guide (Q-by-Q)). Geneva (SW); 2024. Available at:
https://www.who.int/publications/m/item/standard-steps-instrument . - World Health Organization. WHO/PAHO Regional Expert Group for Cardiovascular Disease Prevention through Population-wide Dietary Salt Reduction. Protocol for population-level sodium determination in 24-hr urine samples. Geneva (SW); 2010. 1–40.
- Mill JG, Lamêgo Rodrigues S, Perim Baldo M, Carvalho Malta D, Landmann Szwarcwald C. Validation study of the Tanaka and Kawasaki equations to estimate the daily sodium excretion by a spot urine sample. Rev Bras Epidemiol. 2015;18 Suppl 2:224–37. PMID: 27008617. DOI: 10.1590/1980-5497201500060020
- World Health Organization. Protocol for population level sodium determination in 24-hr urine samples. WHO/PAHO Regional Expert Group for Cardiovascular Disease Prevention through Population-wide Dietary Salt Reduction. Available at:
https://www3.paho.org/hq/dmdocuments/2010/pahosaltprotocol.pdf . - Choudhury SR, Al-Mamun MA, Akhtar J, Sayem MNN, Zahed Z, Rahman MA, et al. Comparison of three spot urine formulae and their validation using 24-hr urine sodium for estimation of daily salt intake: a crosssectional study among Bangladeshi adults. BMJ Open. 2022;12:
e061348 . DOI: 10.1136/bmjopen-2022-061348 - Khan AE, Ireson A, Kovats S, Mojumder SK, Khusru A, Rahman A, et al. Drinking water salinity and maternal health in coastal Bangladesh: Implications of climate change. Environ Health Perspect. 2011;119:1328–32. DOI: 10.1289/ehp.1002804
- Johnson C, Praveen D, Pope A, Raj TS, Pillai RN, Land MA, et al. Mean population salt consumption in India: A systematic review. J Hypertens. 2017;35(1):3–9. DOI: 10.1097/HJH.0000000000001141
- Ghimire K, Mishra SR, Satheesh G, Neupane D, Sharma A, Panda R, et al. Salt intake and salt-reduction strategies in South Asia: From evidence to action. J Clin Hypertens. 2021;23:1815–1829. DOI: 10.1111/jch.14365
- Neupane D, Rijal A, Henry ME, Kallestrup P, Koirala B, Mclachla CSn, et al. Mean dietary salt intake in Nepal: A population survey with 24-hour urine collections. J Clin Hypertens. 2020;00:1–7. DOI: 10.1111/jch.13813
- Reddin C, Ferguson J, Murphy R, Clarke A, Judge C, Griffith V, et al. Global mean potassium intake: A systematic review and Bayesian meta-analysis. Eur J Nutr. 2023;62:2027–2037. DOI: 10.1007/s00394-023-03128-6
- Chailimpamontree W, Kantachuvesiri S, Aekplakorn W, Lappichetpaiboon R, Sripaiboonkij Thokanit N, Vathesatogkit P, et al. Estimated dietary sodium intake in Thailand: A nationwide population survey with 24-hr urine collections. J Clin Hypertens. 2021;23:744–754. DOI: 10.1111/jch.14147
- Islam FMA, Wong CK, Hosen MA, Bhowmik J. Perception of and practice in salt and fruit consumption and their associations with high blood pressure: A study in a rural area in Bangladesh. Appl. Sci. 2023;13:
1622 . DOI: 10.3390/app13031622 - O’Donnell JM, Yusuf S, Mente A, Gao P, Mann JF, Teo K, et al. Urinary sodium and potassium excretion and risk of cardiovascular events. JAMA. 2011;306:2229–2238. DOI: 10.1001/jama.2011.1729
- Ministry of Health and World Health Organization, Country Office for Bangladesh. National STEPS survey for non-communicable diseases risk factors in Bangladesh 2018. Technical document. Dhaka (BG); 2022. Available at:
https://rb.gy/6ie9yu . - He FJ, Campbell NRC, MacGregor GA. Reducing salt intake to prevent hypertension and cardiovascular disease. Rev Panam Salud Publica. 2012;32(4):293–300. DOI: 10.1590/S1020-49892012001000008
- Non-communicable Disease Control Programme, Directorate General of Health Services. Multi-sectoral action plan for prevention and control of non-communicable diseases. 2018–2025. Dhaka (BG); 2018. Available at:
https://cdn.who.int/media/docs/default-source/searo/ncd/ban-ncd-action-plan-2018-2025.pdf?sfvrsn . - McCarron AD. DASH-Sodium Trial: Where Are the Data? Am. J. Hypertens. 2003; 16(1):92–94. DOI: 10.1016/S0895-7061(02)03200-4
- Palmer BF, Clegg DJ. Physiology and pathophysiology of potassium homeostasis. Adv Physiol Educ. 2016;40(4):480–490. DOI: 10.1152/advan.00121.2016
- Palaniveloo L, Ambak R, Othman F, Mohd Zaki NA, Baharudin A, Abdul Aziz NS, et al. Low potassium intake and its association with blood pressure among adults in Malaysia: Findings from the MyCoSS (Malaysian Community Salt Survey). J Health Popul Nutr. 2021;40(Suppl 1):
7 . PMID: 34059161. DOI: 10.1186/s41043-021-00238-x - The Scientific Advisory Committee on Nutrition and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment. A joint statement. Potassium-Based Sodium Replacers: Assessment of the Health Benefits and Risks of Using Potassium-Based Sodium Replacers in Foods in the UK. A Joint Statement from the Scientific Advisory Committee on Nutrition and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment; 2017. Available at:
https://assets.publishing.service.gov.uk/media/5a82b61bed915d74e34032cc/SACN_COT_-_Potassium-based_sodium_replacers.pdf . - Greer RC, Marklund M, Anderson CAM, Cobb LK, Dalcin AT, Henry M, et al. Potassium-enriched salt substitutes as a means to lower blood pressure: Benefits and risks. Hypertension. 2020;75:00–00. DOI: 10.1161/HYPERTENSIONAHA.119.13241
- Marklund M, Tullu F, Thout SR, Yu J, Brady TM, Appel LJ, et al. Estimated benefits and risks of using a reduced-sodium, potassium-enriched salt substitute in India: a modeling study. Hypertension. 2022;79(10):2188–2198. DOI: 10.1161/HYPERTENSIONAHA.122.19072
- Khalequzzaman MD, Chiang C, Choudhury SR, Yatsuya H, Al-Mamun MA, Abdullah Al-Shoaibi AA, et al. Prevalence of noncommunicable disease risk factors among poor shantytown residents in Dhaka, Bangladesh: A community-based cross-sectional survey. BMJ Open. 2017;7:
e014710 . DOI: 10.1136/bmjopen-2016-014710 - He JF, Wu Y, Ma J, Feng X, Wang H, Zhang J, et al. School based education programme to reduce salt intake in children and their families (School-EduSalt): Protocol of a cluster randomised controlled trial. BMJ. 2015;350:
h770 . DOI: 10.1136/bmj.h770 - Pan American Health Organization. Front-of-package warning labels save lives and resources: Results from a modeling study in Barbados; 2023. Available at:
https://iris.paho.org/bitstream/handle/10665.2/57989/PAHONMHRF230040_eng.pdf?sequence=1&isAllowed=y . - Omi RF, Bhuiyan R, Shraboni NN, Barua L, Banik PC, Faruque M, et al. Estimation of sodium and potassium intake level from spot urine samples among urban adults in Bangladesh. Journal of Xiangya Medicine; 2023. DOI: 10.21037/jxym-23-12
- Bigina NRG, Engberink RHGO. Estimation of sodium and potassium intake: Current limitations and future perspectives. Nutrients. 2020;12(11):
3275 . DOI: 10.3390/nu12113275
DOI: https://doi.org/10.5334/gh.1447 | Journal eISSN: 2211-8179
Language: English
Submitted on: Feb 18, 2025
Accepted on: Jun 23, 2025
Published on: Jul 14, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
© 2025 Jubaida Akhtar, Mohammad A. Al-Mamun, Mohammad N.-N. Sayem, Mohammad J. Ahmed, Mahfuzur R. Bhuiyan, Shamim Jubayer, Mohammad R. Amin, Md. R. Karim, Megan E. Henry, Matti Marklund, Laura Cobb, Dinesh Neupane, Lawrence J. Appel, Sohel R. Choudhury, published by Ubiquity Press
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