Renal Section, Medical Service, Veterans Affairs North Texas Health Care System, Dallas, TX 75216-7167, USA.
Clin J Am Soc Nephrol. 2012 Feb;7(2):315-22. doi: 10.2215/CJN.02060311. Epub 2011 Nov 23.
Previous studies reporting an association between high BP and high sodium and low potassium intake or urinary sodium/potassium ratio (U[Na(+)]/[K(+)]) primarily included white men and did not control for cardiovascular risk factors.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This cross-sectional study investigated the association of U[Na(+)]/[K(+)] with BP in 3303 participants using robust linear regression.
Mean age was 43±10 years, 56% of participants were women, and 52% were African American. BP was higher in African Americans than in non-African Americans, 131/81±20/11 versus 120/76±16/9 mmHg (P<0.001). Mean U[Na(+)]/[K(+)] was 4.4±3.0 in African Americans and 4.1±2.5 in non-African Americans (P=0.002), with medians (interquartile ranges) of 3.7 (3.2) and 3.6 (2.8). Systolic BP increased by 1.6 mmHg (95% confidence interval, 1.0, 2.2) and diastolic BP by 1.0 mmHg (95% confidence interval, 0.6, 1.4) for each 3-unit increase in U[Na(+)]/[K(+)] (P<0.001 for both). This association remained significant after adjusting for diabetes mellitus, smoking, body mass index, total cholesterol, GFR, and urine albumin/creatinine ratio. There was no interaction between African-American race and U[Na(+)]/[K(+)], but for any given value of U[Na(+)]/[K(+)], both systolic BP and diastolic BP were higher in African Americans than in non-African Americans. The diastolic BP increase was higher in men than in women per 3-unit increase in U[Na(+)]/[K(+)] (1.6 versus 0.9 mmHg, interaction P=0.03).
Dietary Na(+) excess and K(+) deficiency may play an important role in the pathogenesis of hypertension independent of cardiovascular risk factors. This association may be more pronounced in men than in women.
先前报告血压（BP）与高钠和低钾摄入或尿钠/钾比值（U[Na(+)]/[K(+)]）之间存在关联的研究主要包括白人男性，且未对心血管危险因素进行控制。
设计、地点、参与者和测量方法：本横断面研究使用稳健线性回归分析了 3303 名参与者的 U[Na(+)]/[K(+)]与 BP 的关系。
平均年龄为 43±10 岁，56%的参与者为女性，52%为非裔美国人。非裔美国人的 BP 高于非非裔美国人，分别为 131/81±20/11 与 120/76±16/9 mmHg（P<0.001）。非裔美国人的平均 U[Na(+)]/[K(+)]为 4.4±3.0，非非裔美国人的为 4.1±2.5（P=0.002），中位数（四分位距）分别为 3.7（3.2）和 3.6（2.8）。U[Na(+)]/[K(+)]每增加 3 单位，收缩压增加 1.6 mmHg（95%置信区间，1.0，2.2），舒张压增加 1.0 mmHg（95%置信区间，0.6，1.4）（均 P<0.001）。在调整糖尿病、吸烟、体重指数、总胆固醇、肾小球滤过率和尿白蛋白/肌酐比值后，这种关联仍然显著。非裔美国人种族与 U[Na(+)]/[K(+)]之间没有交互作用，但对于 U[Na(+)]/[K(+)]的任何给定值，非裔美国人的收缩压和舒张压均高于非非裔美国人。U[Na(+)]/[K(+)]每增加 3 单位，男性的舒张压升高高于女性（1.6 与 0.9 mmHg，交互作用 P=0.03）。
膳食钠过量和钾缺乏可能在独立于心血管危险因素的高血压发病机制中发挥重要作用。这种关联在男性中可能比女性更明显。
