A cross-sectional, observational study of 2 genotyped cohorts in Australia and UK suggested that sodium was associated with larger hypertensive effects for individuals with higher blood pressure (BP) genetic risk in pathways related to sodium and potassium biology. Both genetic risk and urinary electrolytes independently correlated with BP in the UK cohort of 296 475 participants. However, urinary sodium was associated with a larger BP increase among individuals with higher genetic risk in sodium- and potassium-related pathways than in those with comparatively lower genetic risk. Each SD in urinary sodium was associated with a 1.47–mm Hg increase in systolic BP for those in the top 10% versus a 0.97–mm Hg systolic BP increase in the lowest 10% of the distribution of genetic risk in sodium and potassium transport pathways. This interaction with urinary sodium remained when considering estimated glomerular filtration rate and indexing sodium to urinary creatinine. The pharmagenic enrichment score for sodium/potassium transport appeared to be more specifically related to the interplay between urinary electrolytes and BP, as there was no strong evidence of an interaction between urinary sodium and a standard genome-wide polygenic score of BP. A large body of evidence shows that the sodium to potassium ratio of 1:1 or lower may help BP control with significant heterogeneity in response to dietary interventions. Genetic risk scores in sodium and potassium pathways may prove useful to identify individuals who respond differently to interventions targeting these electrolytes. Higher sodium-to-potassium ratios are also associated with poorer diet quality. Source: https://www.ahajournals.org/
