Mineral Intake Ratios Are a Weak but Significant Factor in Blood Pressure Variability in US Adults

Background: Hypertension contributes substantially to chronic disease and mortality. Mineral intakes can modify blood pressure. Objective: Individual minerals and their intake ratios in US adults and their association with blood pressure were examined. Methods: Regression models were used to examine the associations of sodium, potassium, and calcium intakes and their ratios from food and supplements with blood pressure in 8777 US adults without impaired renal function from the 2011-2014 NHANES. We evaluated men (n = 4395) and women (n = 4382) separately. Models for predicting blood pressure were developed using age, blood pressure medication, race, body mass index (BMI), and smoking as explanatory variables. Results: Few adults met the recommended intake ratios for sodium: potassium (1.2% and 1.5%), sodium: calcium (12.8% and 17.67%), and sodium: magnesium (13.7% and 7.3%) for men and women, respectively. Approximately half of adults (55.2% of men and 54.8% of women) met calcium: magnesium intake ratio recommendations. In our regression models, the factors that explained the largest amount of variability in blood pressure were age, blood pressure medication, race/ethnicity, BMI, and smoking status. Together, these factors explained 31% and 15% of the variability in systolic blood pressure in women and men, respectively. The sodium: potassium (men and women), sodium: magnesium (women), and sodium: calcium (men) intake ratios were positively associated with systolic blood pressure, whereas calcium intake was inversely associated with systolic blood pressure in men only. When mineral intake ratios were added individually to our regression models, they improved the percentage of variability in blood pressure explained by the model by 0.13-0.21%. Conclusions: Strategies to lower blood pressure are needed. Lower sodium: potassium intake ratios provide a small benefit for protection against hypertension in US adults.