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American Journal of Epidemiology Vol. 142, No. 3: 295-303
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health

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The Contribution of Urinary Cations to the Blood Pressure Differences Associated with Migration

Michael J. Klag1,2,3,4,, Jiang He1,3,5, Josef Coresh1,2,3, Paul K. Whelton1,2,3, Jun-Yun Chen7, Jing-Ping Mo5, Ming-Chu Qian7, Pei-Sheng Mo6 and Guan-Qing He5

1Welch Center for Prevention, Epidemiology, and Clinical Research, Schools of Medicine and Hygiene and Public Health, The Johns Hopkins University Baltimore, MD.
2Department of Medicine, School of Medicine, The Johns Hopkins University Baltimore, MD.
3Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD.
4Department of Health Policy and Management, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD.
5Peking Union Medical College and Chinese Academy of Medical Sciences Beijing, People's Republic of China.
6National Center for Clinical Laboratories, Ministry of Public Health Beijing, People's Republic of China.
7Liangshan Yi People Autonomous Prefecture Anti-epidemic Station Xichang City, Sichuan Province, People's Republic of China.

Reprint requests to Dr. Michael J. Klag, Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21205-2223.1

People living in unacculturated societies have a low average blood pressure and little rise in blood pressure with age. In a community-based survey in southwestern China, the authors assessed the contribution of urinary cation excretion to differences in blood pressure between an unacculturated group (Yi farmers) and migrants to an urban environment, as well as urban controls from a different ethnic group (Han). In March 1989, blood pressure and overnight urinary electrolyte levels were measured on 3 consecutive days in 313 Yi farmers, 265 Yi migrants, and 253 urban Han residents, all male. Of the urinary electrolytes, a higher sodium: potassium ratio best explained the higher blood pressure in the migrants. Yi farmers had lower systolic (106.7 mmHg vs. 114.8 mmHg, respectively) and diastolic (66.2 mmHg vs. 71.3 mmHg, respectively) blood pressures than Yi migrants. However, even after adjustment for age, body mass index, alcohol intake, and urinary sodium, potassium, calcium, and magnesium excretion, Yi farmers continued to have lower average blood pressures than Yi migrants. In pooled analyses of all three groups, urinary sodium and calcium were positively related and urinary potassium and magnesium were inversely related to blood pressure. Migration is associated with a higher blood pressure that is only partially explained by higher levels of adiposity and alcohol and sodium intake and lower levels of potassium and magnesium intake.

blood pressure; electrolytes; hypertension; nutrition; transients and migrants


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