Department of Medicine, Hadassah-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel.
J Hypertens. 2013 May;31(5):900-5. doi: 10.1097/HJH.0b013e32835f29f4.
Salt-sensitivity is difficult to assess with salt diet.
: Salt-sensitivity risk was estimated from ambulatory blood pressure monitoring indices, patient data, and 20-year all-cause mortality. Tracings of 2064 untreated patients from our clinical monitoring service were evaluated for the prevalence and associations of salt-sensitivity risk, which was considered low in patients with both mean arterial pressure dipping more than 10% and 24-h heart rate less than 70 bpm; high in patients with dipping 10% or less and 24-h heart rate at least 70 bpm; and intermediate in patients with the other combinations.
Low, intermediate, and high salt-sensitivity categories were predicted for 33% (366/1099), 57% (624/1099), and 10% (109/1099) of men and 18% (177/965), 67% (630/965), and 16% (158/965) of women, respectively (χ(2) < 0.0001). Positive linear trends were noted between salt-sensitivity and BMI, clinic and 24-h ambulatory blood pressure, awake and sleep ambulatory heart rate and awake and sleep blood pressure variability, and negative trend with heart rate dipping (all P < 0.005). Kaplan-Meier analyses revealed increased mortality in association with salt-sensitivity in men but not in women (P < 0.02). With low and intermediate salt-sensitivity as reference, adjusted Cox proportional hazard ratios for all-cause mortality associated with high sensitivity were 1.96 (95% confidence interval 1.07-3.62) in men and 1.02 (0.51-2.07) in women.
To the extent that ambulatory blood pressure-derived estimation of salt-sensitivity is feasible, analysis of our database suggests increased mortality risk in men but not in women, in whom salt-sensitivity was more common.
用盐饮食来评估盐敏感性比较困难。
从动态血压监测指标、患者数据和 20 年全因死亡率来估计盐敏感性风险。我们的临床监测服务中的 2064 名未经治疗的患者的记录被评估了盐敏感性风险的患病率和相关性，在平均动脉压下降超过 10%和 24 小时心率低于 70 次/分的患者中被认为风险低；在下降 10%或更少和 24 小时心率至少 70 次/分的患者中被认为风险高；在其他组合的患者中被认为风险中。
低、中、高盐敏感性类别分别预测男性的 33%（366/1099）、57%（624/1099）和 10%（109/1099），女性的 18%（177/965）、67%（630/965）和 16%（158/965）（χ²<0.0001）。盐敏感性与 BMI、诊所和 24 小时动态血压、清醒和睡眠动态心率以及清醒和睡眠血压变异性之间呈正线性趋势，与心率下降呈负趋势（均 P<0.005）。Kaplan-Meier 分析显示，盐敏感性与男性的死亡率增加相关，但与女性无关（P<0.02）。以低和中盐敏感性为参照，与高敏感性相关的全因死亡率的调整 Cox 比例风险比在男性中为 1.96（95%置信区间 1.07-3.62），在女性中为 1.02（0.51-2.07）。
在一定程度上，基于动态血压监测的盐敏感性估计是可行的，我们的数据库分析表明，盐敏感性男性的死亡率风险增加，但女性没有，女性的盐敏感性更为常见。
