By this paper, potassium intake increase has been emphasised in addition to salt (sodium) reduction for the prevention of hypertension and cardiovascular diseases in Japan.” Professor Katsuyuki Miura, Co-principal investigator of the NIPPON DATA Research Group; director and professor, NCD Epidemiology Research Center (NERC), Shiga University of
Shaping national dietary guidance to prevent hypertension in Japan
Medical Science (SUMS), Seta-Tsukinowa-cho, Otsu, Shiga, Japan
In 2016, when researchers from leading Japanese institutions published their study in BMJ Open, they showed that dietary balance, not salt reduction alone, is a significant predictor of stroke, cardiovascular, and all-cause mortality in a national cohort followed over 24 years. A decade later, the paper, Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study, 39 remains highly relevant, contributing to the evidence base for the Japanese Society of Hypertension 2024 Consensus Statement on urinary sodium-to-potassium ratio 40 and the 2025 Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension. 41
It was also cited alongside two papers in The BMJ 42 on sodium and blood pressure in the 2026 Japanese Society of Hypertension Guidelines for Blood Pressure Control Using Digital Technologies, 43 demonstrating the sustained contribution of BMJ Group evidence to national guidance on hypertension prevention and cardiovascular risk reduction. BMJ Impact Analytics shows that this influence extends across policy and clinical guidance. The paper is linked to 29 policy and guidance documents across two countries, including 28 from the Government of Japan. The research has informed prevention policy and has been cited in documents on potassium, hypertension, salt, diabetes, pregnancy, body weight, breastfeeding, and lifestyle disease.
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