Associations between Estimation of Salt Intake and Salt-Restriction Spoons and Hypertension Status in Patients with Poorly Controlled Hypertension: A community-based Study from Huzhou City, Eastern China

Background: As the prevalence of hypertension increases in China, it is advised to incorporate the use of salt-restriction spoons (SRS) as a lifestyle modification. This study aimed to examine the associations between estimated salt consumption, SRS usage, and the hypertension status in individuals with poorly controlled hypertension. Methods Data was collected in Huzhou City, Zhejiang Province, in 2021 using convenience sampling. The analysis involved univariate and multilevel ordinal logistic regression to assess the relevant factors. Results The study found that 73.34% of the 1215 patients had uncontrolled blood pressure. Urinary excretion was assessed through the utilization of the Kawasaki, INTERSALT, and Tanaka formulas. The outcomes of these three methodologies revealed average daily sodium excretion values of 208.70 (65.65), 154.78 (33.91), and 162.61 (40.87) mmol, respectively. The prevalence of utilizing SRS was found to be 37.78% in this study. Despite the acknowledgment among SAS users of the potential hazards associated with excessive salt consumption, there exists a contradictory pattern of attitudes and behaviors concerning salt reduction. Several risk factors, including being overweight or obese, alcohol consumption, and an increasing number of medications, were found to significantly impact blood pressure control (P < 0.05). A positive correlation was observed between salt restriction and hypertension status (Kawasaki adjusted OR = 0.58, 95% CI = 0.43–0.79; INTERSALT adjusted OR = 0.62, 95% CI = 0.41–0.92; Tanaka adjusted OR = 0.61, 95% CI = 0.45–0.92, p < 0.05) when controlling for other variables among individuals with varying levels of salt intake (quartiles 1–4, Q1 vs Q4). Our research also revealed that using or used SAS was a protective factor for blood pressure control (adjusted OR = 0.79, 95% CI = 0.64–0.99, P < 0.05). Conclusions Salt reduction campaigns are necessary in order to address the issue of hypertension. Patients with uncontrolled hypertension can effectively lower their blood pressure by reducing their sodium intake, preferably by utilizing SRS during home cooking in the region. In order to alleviate the burden of hypertension in China, further research is needed to develop interventions that can improve patient outcomes.