Epidemiological Studies on the Relationship Between Sodium, Potassium, Calcium, and Magnesium and Arterial Blood Pressure

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Abstract
Populations with a high sodium intake have a high prevalence of hypertension and a high mortality and morbidity due to cerebrovascular disease. Within populations, however, it is very difficult to demonstrate a significant correlation between sodium intake and blood pressure. Experimental evidence exists demonstrating a blood pressure-lowering effect of potassium. In Korea, where sodium consumption is very high, we were able to demonstrate a positive relationship between sodium intake and a negative relationship between potassium intake and blood pressure. We were unable, however, to demonstrate such an effect in Belgium. Total serum calcium positively correlates with blood pressure in Belgium in male subjects, while 24-h urinary excreted calcium positively correlates with blood pressure both in Korea and in Belgium. Significant interactions exist between the amount of sodium and potassium in the 24-h urine and the total serum calcium level. In a subgroup of 297 male subjects no correlation was found between the serum ionized calcium level and blood pressure. Magnesium, a calcium antagonist, could be the factor responsible for the relationship between water hardness and cardiovascular morbidity. In Korea, however, we were unable to find a significant relationship between 24-h urinary magnesium and both systolic and diastolic blood pressure.

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