The present epidemiological study aimed to evaluate the association of serum electrolyte levels with hypertension in a population with a high-salt diet.

Secondary analysis of epidemiology data from the Northeast China Rural Cardiovascular Health Study conducted in 2012–2013. Blood pressure and hypertension status were analysed for association with serum sodium, potassium, chloride, total calcium, phosphate and magnesium levels using regression models.

High-salt diet, rural China.

Adult residents in Liaoning, China.

In total 10 555 participants were included, of whom 3287 had incident hypertension (IH) and 1655 had previously diagnosed hypertension (PDH). Fifty-six per cent of participants had electrolyte disturbance. Sixty-two per cent of hypercalcaemic participants had hypertension, followed by hypokalaemia (56 %) and hypernatraemia (54 %). Only hypercalcaemia showed significant associations with both IH (OR=1·70) and PDH (OR=2·25). Highest serum calcium quartile had higher odds of IH (OR=1·58) and PDH (OR=1·64) than the lowest quartile. Serum sodium had no significant correlation with hypertension. Serum potassium had a U-shaped trend with PDH. Highest chloride quartile had lower odds of PDH than the lowest chloride quartile (OR=0·65). Highest phosphate quartile was only associated with lower odds of IH (OR=0·75), and the higher magnesium group had significantly lower odds of IH (OR=0·86) and PDH (OR=0·77).

We have shown the association of serum calcium, magnesium and chloride levels with IH and/or PDH. In the clinical setting, patients with IH may have concurrent electrolyte disturbances, such as hypercalcaemia, that may indicate other underlying aetiologies.