肯尼亚卢奥族移民研究：关于血压升高起始情况的观察
The Kenyan Luo migration study: observations on the initiation of a rise in blood pressure.
作者信息
Poulter N R, Khaw K T, Hopwood B E, Mugambi M, Peart W S, Rose G, Sever P S
机构信息
St Mary's Hospital, London.
出版信息
BMJ. 1990 Apr 14;300(6730):967-72. doi: 10.1136/bmj.300.6730.967.
OBJECTIVE
To demonstrate the magnitude, timing, and cause of changes in blood pressure that occur in migrants from a low blood pressure population on moving to an urban area.
DESIGN
A controlled longitudinal observational study of migrants as soon after migration as possible and follow up at three, six, 12, 18, and 24 months after migration. A cohort of controls living in a rural area who were matched for age, sex, and locality were also observed at the same periods.
SETTING
35 Villages on the northern shores of Lake Victoria in western Kenya and Nairobi.
PARTICIPANTS
325 Members of the Luo tribe aged 15 to 34 years who had migrated to Nairobi and 267 controls living in villages. The numbers of both groups reduced during follow up such that only 63 migrants and 143 controls were followed up for two years.
MAIN OUTCOME MEASURES
A medical questionnaire and three 24 hour diet histories were completed by migrants and controls. Height, weight, pulse, and blood pressure were measured. Three 12 hour overnight urine samples were collected from all participants and analysed for sodium, potassium, and creatinine concentrations.
RESULTS
The mean systolic blood pressure of migrants was significantly higher than that of controls throughout the study, and the distribution of blood pressure was shifted to the right compared with controls. The mean diastolic blood pressure of the two groups diverged over time. Blood pressure differences were not due to selective migration. The migrants' mean urinary sodium:potassium ratio was higher than that of controls (p less than 0.001) throughout, and weight and pulse rate were also higher among migrants, although differences diminished with time.
CONCLUSIONS
Urinary sodium:potassium ratio, pulse rate, and weight are important predictors of increased blood pressure among migrants from a low blood pressure community and may also be implicated in the initiation of essential hypertension.
目的
揭示来自低血压人群的移民迁至城市地区后血压变化的幅度、时间及原因。
设计
一项对照纵向观察研究，对移民在迁移后尽快进行研究，并在迁移后3个月、6个月、12个月、18个月和24个月进行随访。同时在相同时间段观察一组年龄、性别和居住地点相匹配的农村对照人群。
地点
肯尼亚西部维多利亚湖北岸的35个村庄及内罗毕。
参与者
325名年龄在15至34岁之间的卢奥部落成员，他们已移民至内罗毕，以及267名居住在村庄的对照者。两组人数在随访期间均有所减少，以至于只有63名移民和143名对照者接受了两年的随访。
主要观察指标
移民和对照者完成一份医学问卷及三份24小时饮食史调查。测量身高、体重、脉搏和血压。从所有参与者中收集三份12小时夜间尿液样本，并分析其中钠、钾和肌酐的浓度。
结果
在整个研究过程中，移民的平均收缩压显著高于对照者，且血压分布相对于对照者向右偏移。两组的平均舒张压随时间推移出现差异。血压差异并非由选择性迁移所致。移民的平均尿钠钾比始终高于对照者（p<0.001），移民的体重和脉搏率也更高，尽管差异随时间减小。
结论
尿钠钾比、脉搏率和体重是来自低血压社区的移民血压升高的重要预测因素，也可能与原发性高血压的发病有关。
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