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Background There have been few studies on the relationship between long‐term changes in sodium intake and blood pressure. A method of reducing sodium intake in a population that is known for high‐sodium intake based on homemade cooking is also needed. Methods and Results Our study was based on a baseline survey of 15 350 individuals aged 18 to 69 years with multistage random sampling and a 3‐year salt‐restriction campaign across Shandong Province, China. We included 339 individuals from six districts/counties in this cohort study, and the 24‐hour urinary sodium‐potassium ratio (Na+ /K+ ) served as an indicator of sodium intake. The average change in ratio was 2.39 (95% CI, 2.17–2.61) from 6.81 (95% CI, 6.41–7.21) at baseline to 4.41 (95% CI, 4.18–4.64) during the resurvey. Following a reduction from low to high quartiles of urinary Na+ /K+ ratio, the average increases were 10.9 (95% CI, 8.9–12.9), 9.2 (95% CI, 6.9–11.5), 6.3 (95% CI, 4.0–8.6), and 5.3 (95% CI, 2.9–7.7) mm Hg for systolic blood pressure (P for trend=0.019) and 3.8 (95% CI, 2.4–5.2), 2.9 (95% CI, 1.7–4.2), 1.6 (95% CI, 0.4–2.8), and −0.3 (95% CI, −1.4–0.8) mm Hg for diastolic blood pressure (P for trend=0.002), respectively. A reduction in salt intake was evident for people using a 2‐g salt‐restriction spoon for cooking (−3.49 versus −2.22;P =0.027) after adjustment of confounding factors, compared with nonusers. Similar findings were obtained for other salt‐restriction spoon–based indicators.Conclusions Our study indicated that using a salt‐restriction spoon for cooking was associated with reduced salt intake that led to a blunting of blood pressure deterioration. This finding further supports the salt‐restriction spoon–based strategy for people whose primary salt intake is from homemade cooking.

journal of the american heart association. cardiovascular and cerebrovascular disease

Associations Between Salt‐Restriction Spoons and Long‐Term Changes in Urinary Na <sup>+</sup> /K <sup>+</sup> Ratios and Blood Pressure: Findings From a Population‐Based Cohort

Associations Between Salt‐Restriction Spoons and Long‐Term Changes in Urinary Na + /K + Ratios and Blood Pressure: Findings From a Population‐Based Cohort

Associations Between Salt‐Restriction Spoons and Long‐Term Changes in Urinary Na ⁺ /K ⁺ Ratios and Blood Pressure: Findings From a Population‐Based Cohort