Takamura I
Department of Cardiovascular Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1991 Jul;66(4):492-501.
We all agree to the importance of the salt restriction in the prevention and the treatment of hypertension. But it is not easy to teach the way to reduce salt intake in each person or patient. And we also not confident that how long could they maintain the low salt diet. In this study we investigate following problems, 1) Can the salt intake be reduced in public population? 2) Can blood pressure be lowered by reducing salt intake in mildly hypertensive individuals? 3) If the desired changes are obtained, can they be preserved for a long time? and 4) Are there any difference in the amount of the salt intake between hypertensives and normotensives? One hundred and forty subjects from 23,940 people in whom borderline to mild hypertension was found at group medical examinations in each district, where a total of 29,940 people were examined, were registered to a educational course of new salt-restriction program. Salt intake was estimated from salt measurement in 24-hour urine samples. Educational program was composed of many lectures, sampling party and individualized consultations about dietary problems, using an original dietary questionnaire list. The results were as follows: In short-term (2.5 months) after the initial education, sodium intake reduced from 235.1 +/- 110.8 mmol/day to 161.4 +/- 85.0 mmol/day (p less than 0.001). The systolic and diastolic blood pressure also fell significantly in borderline hypertensives (from 148 +/- 7/87 +/- 5 mmHg to 141 +/- 12/85 +/- 7 mmHg, p less than 0.001) and hypertensives (from 165 +/- 13/99 +/- 8 mmHg to 157 +/- 15/95 +/- 8 mmHg, p less than 0.001) but they did not change in normotensives (from 133 +/- 6/80 +/- 6 mmHg to 131 +/- 9/82 +/- 8 mmHg). In long-term (range from 12 to 36 months) observation, low salt diet (167.6 +/- 72 mmol/day) and a fall in blood pressure were also maintained in borderline (142 +/- 2/85 +/- 7 mmHg, p less than 0.001) to hypertensive population (156 +/- 14/93 +/- 8 mmHg, p less than 0.001), and in the normotensive population, no change in blood pressure was observed (134 +/- 13/82 +/- 9 mmHg). Hypertensives tended to show higher sodium intake than normotensives (206 +/- 101 mmol/day vs. 199.0 +/- 96, p less than 0.005), and also show higher sodium/potassium ratio than normotensives and borderline hypertensives (4.3 +/- 2.3 vs. 3.6 +/- 1.6 and 3.8 +/- 1.8, p less than 0.005).(ABSTRACT TRUNCATED AT 400 WORDS)
我们都认同限制盐摄入在预防和治疗高血压方面的重要性。但要教会每个人或每位患者减少盐摄入量的方法并非易事。而且我们也不确定他们能将低盐饮食维持多久。在本研究中,我们调查了以下问题:1)普通人群的盐摄入量能否降低?2)轻度高血压个体通过减少盐摄入量能否降低血压?3)如果实现了预期的变化,这些变化能否长期保持?以及4)高血压患者和血压正常者的盐摄入量是否存在差异?在每个区的集体体检中,从总共29940名接受检查的人群中发现有临界至轻度高血压的23940人中选取了140名受试者,他们参加了新的限盐计划教育课程。通过检测24小时尿样中的盐含量来估算盐摄入量。教育计划包括多次讲座、样本采集活动以及使用原始饮食问卷清单进行的关于饮食问题的个性化咨询。结果如下:在初始教育后的短期(2.5个月)内,钠摄入量从235.1±110.8 mmol/天降至161.4±85.0 mmol/天(p<0.001)。临界高血压患者(收缩压和舒张压从148±7/87±5 mmHg降至141±12/85±7 mmHg,p<0.001)和高血压患者(从165±13/99±8 mmHg降至157±15/95±8 mmHg,p<0.001)的收缩压和舒张压也显著下降,但血压正常者(从133±6/80±6 mmHg降至131±9/82±8 mmHg)的血压未发生变化。在长期(12至36个月)观察中,临界(142±2/85±7 mmHg,p<0.001)至高血压人群(156±14/93±8 mmHg,p<0.001)仍维持低盐饮食(167.6±72 mmol/天)且血压下降,而血压正常人群未观察到血压变化(134±13/82±9 mmHg)。高血压患者的钠摄入量往往高于血压正常者(206±101 mmol/天对199.0±96,p<0.005),并且其钠/钾比值也高于血压正常者和临界高血压患者(4.3±2.3对3.6±1.6和3.8±1.8,p<0.005)。(摘要截断于400字)