CLINICIAN PRACTICE REGARDING SODIUM AND POTASSIUM INTAKE MONITORING IN PATIENTS WITH HYPERTENSION

Objective: High sodium intake is associated with an increased blood pressure and risk of cardiovascular disease, whereas a high potassium intake is associated with a decrease in blood pressure and reduced risk of cardiovascular events. Therefore, the European Society of Hypertension (ESH) recommends a sodium intake below 5 g/day and a potassium intake above 3.5 g/day. In this study we aimed to evaluate the clinician’s practice regarding advice and monitoring of sodium and potassium intake. Design and method: An online questionnaire was distributed to members of the ESH Working Group on Hypertension and the Kidney and the ESH Working Group on Lifestyle, Cardiovascular Pharmacotherapy and Adherence. Members were encouraged to share the questionnaire with colleagues in their country. We excluded participants who completed less than 85% of the questionnaire. The collected data were analyzed using descriptive statistics. Results: We included 121 physicians from 24 countries (Figure A). Their median age was 47 (IQR 38-56) and 40% were female. Predominantly nephrologists filled out the questionnaire (61%), followed by internal medicine specialists (37%) and cardiologists (10%). Of these participants, 93% agreed that patients with hypertension should lower their salt intake to below 5 g/day, whereas 74% regularly advises their hypertensive patients to lower their salt intake. For potassium intake, 58% believed that a high-potassium diet should be recommended to hypertensive patients. Forty-three percent never advises their hypertensive patients to increase daily potassium intake. Eighty-two clinicians (68%) monitor sodium intake and 54 clinicians (46%) monitor potassium intake. A single 24-hour urine collection was used more often for monitoring of sodium or potassium intake than a spot urine sample or dietary assessment tools (Figure B).Conclusions: ESH recommendations on daily potassium intake are less adopted by hypertension physicians than sodium intake recommendations. Additionally, there is a mismatch between beliefs on optimal intake, patient advice, and monitoring for both minerals. Our data suggest that blood pressure control may be improved by increasing the awareness of sodium and potassium intake targets.