低钠摄入与头痛风险：老年人非药物干预试验的结果
Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly.
作者信息
Chen Liwei, Zhang Zhenzhen, Chen Wen, Whelton Paul K, Appel Lawrence J
机构信息
Liwei Chen is with the Department of Public Health Sciences, Clemson University, Clemson, SC. Zhenzhen Zhang is with the School of Public Health, Oregon Health & Science University, Portland. Wen Chen is with the Department of Pathology, VA Medical Center, Washington, DC. Paul K. Whelton is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Lawrence J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
出版信息
Am J Public Health. 2016 Jul;106(7):1270-5. doi: 10.2105/AJPH.2016.303143. Epub 2016 Apr 14.
OBJECTIVES
To determine the effect of sodium (Na) reduction on occurrence of headaches.
METHODS
In the Trial of Nonpharmacologic Interventions in the Elderly, 975 men and woman (aged 60-80 years) with hypertension were randomized to a Na-reduction intervention or control group and were followed for up to 36 months. The study was conducted between 1992 and 1995 at 4 clinical centers (Johns Hopkins University, Wake Forest University School of Medicine, Robert Wood Johnson Medical School, and the University of Tennessee).
RESULTS
Mean difference in Na excretion between the Na-reduction intervention and control group was significant at each follow-up visit (P < .001) with an average difference of 38.8 millimoles per 24 hours. The occurrence of headaches was significantly lower in the Na-reduction intervention group (10.5%) compared with control (14.3%) with a hazard ratio of 0.59 (95% confidence interval = 0.40, 0.88; P = .009). The risk of headaches was significantly associated with average level of Na excretion during follow-up, independent of most recent blood pressure. The relationship appeared to be nonlinear with a spline relationship and a knot at 150 millimoles per 24 hours.
CONCLUSIONS
Reduced sodium intake, currently recommended for blood pressure control, may also reduce the occurrence of headaches in older persons with hypertension.
目的
确定钠（Na）摄入量减少对头痛发生的影响。
方法
在老年人非药物干预试验中，975名年龄在60至80岁之间的高血压男性和女性被随机分为钠摄入量减少干预组或对照组，并随访长达36个月。该研究于1992年至1995年在4个临床中心（约翰霍普金斯大学、维克森林大学医学院、罗伯特·伍德·约翰逊医学院和田纳西大学）进行。
结果
在每次随访时，钠摄入量减少干预组和对照组之间的钠排泄平均差异均具有统计学意义（P < 0.001），平均差异为每24小时38.8毫摩尔。与对照组（14.3%）相比，钠摄入量减少干预组的头痛发生率显著更低（10.5%），风险比为0.59（95%置信区间 = 0.40, 0.88；P = 0.009）。头痛风险与随访期间钠排泄的平均水平显著相关，与最近的血压无关。这种关系似乎是非线性的，呈样条关系，节点为每24小时150毫摩尔。
结论
目前推荐用于控制血压的减少钠摄入量，可能也会降低老年高血压患者头痛的发生率。
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