The opposing association of diet and serum sodium with the prevalence of hypertension in the US adult general population: A cross-section study

This study was designed to explore the cross-sectional association between dietary and serum sodium levels and the risk of hypertension within the general US population. A total of 15,349 adult participants were obtained from the National Health and Nutrition Examination Survey from 2011 to 2018. Weighted logistic regression analyses were employed to examine the associations between dietary and serum sodium and hypertension. The weighted restricted cubic spline was constructed based on the fully adjusted model to explore the dose-response relationship. Additionally, further stratified analyses were carried out. All data handling and analyses were executed using the "Survey" package in R software (Version 4.4.1). The mean age of the study population was 47.53 ± 0.33 years, with an average body mass index of 29.36 ± 0.12 kg/m2. Males accounted for 48.11%, and the weighted prevalence of hypertension was 38.14%. This study uncovered a positive association between the highest quartile of dietary sodium intake and the risk of hypertension among older adults, females, overweight or obese individuals, nonsmokers and nondrinkers, those with low levels of physical activity, and those without cardiovascular diseases. Moreover, a "V"-shaped nonlinear relationship was identified between serum sodium levels and the risk of hypertension among older, sedentary participants. Adopting a low-sodium diet and maintaining serum sodium levels at around 141 mmol/L may confer significant health advantages. Such an approach holds the potential to decrease the risk of hypertension and enhance overall cardiovascular health.