高盐摄入与心血管事件风险较高相关：对一组高血压患者进行的7.2年评估。

High salt intake is associated with a higher risk of cardiovascular events: a 7.2-year evaluation of a cohort of hypertensive patients.

作者信息

Polonia Jorge, Monteiro José, Almeida Joana, Silva José A, Bertoquini Susana

机构信息

aDepartment of Medicine and Cintesis, Faculty of Medicine of Porto University, Porto bHypertension Unit, Hospital Pedro Hispano, Matosinhos, Portugal.

出版信息

Blood Press Monit. 2016 Oct;21(5):301-6. doi: 10.1097/MBP.0000000000000205.

DOI:10.1097/MBP.0000000000000205

PMID:27495189

Abstract

BACKGROUND

It is controversial whether high salt intake is directly associated with cardiovascular (CV) events and how far this relation is independent of blood pressure (BP). As Portugal has higher salt consumption and higher mortality by stroke than other European countries, we examined whether salt intake could predict the development of stroke and CV events in a hypertensive population.

METHODS

In a longitudinal retrospective study of a cohort of 608 adult treated hypertensive patients 54.1±14.3 years of age, BMI 29.3±8.3 kg/m, 56.3% women and 17.1% diabetics, we evaluate the long-term prognostic significance of urinary sodium (UNa) excretion measured in 24 h valid samples within the first 3 months after admission along with 24 h ambulatory blood pressure monitoring and pulse wave velocity [(PWV), complior)] measurements.

RESULTS

The mean follow-up duration was 7.2 years (0.5-11.1 years), during which 122 CV events occurred including 80 strokes and 36 coronary events. In 608 patients (group A=507 without events and group B=101 with events: 69 strokes, 26 coronary events, six others), the mean 24 h UNa was 208±79 mmol/day, corresponding to a salt intake of 12.1±4.6 g/day. Twenty-four hours UNa correlated positively with BMI, PWV and systolic blood pressure (SBP) particularly with night-time SBP. Group B versus A showed higher UNa (260+98 vs. 198+71 mmol/day, P<0.001) and higher PWV, BP office, 24 h, daytime and night-time SBP. Logistic regression analysis identified age, night-time SBP and 24 h UNa+ [HR=1.09 (95% CI, 1.06-1.12, P<0.001)] for each 10 mmol increase of UNa+ as the only independent predictors of CV events. UNa+ above the median (189 mmol sodium/day) predicted CV events with HR=2.99 (95% CI, 1.75-5.13, P<0.001) with worse CV event-free survival rates (log rank statistics of 17.44, P<0.001).

CONCLUSION

In a cohort of hypertensive patients, high salt intake independently predicts the occurrence of CV events, particularly of stroke.

摘要

背景

高盐摄入是否与心血管（CV）事件直接相关，以及这种关系在多大程度上独立于血压（BP），这存在争议。由于葡萄牙的盐摄入量高于其他欧洲国家，且中风死亡率也更高，我们研究了盐摄入量是否能预测高血压人群中风和CV事件的发生。

方法

在一项对608例年龄为54.1±14.3岁、BMI为29.3±8.3kg/m²、女性占56.3%、糖尿病患者占17.1%的成年高血压患者队列进行的纵向回顾性研究中，我们评估了入院后前3个月内24小时有效样本中测量的尿钠（UNa）排泄量的长期预后意义，同时进行了24小时动态血压监测和脉搏波速度[（PWV），Complior]测量。

结果

平均随访时间为7.2年（0.5 - 11.1年），在此期间发生了122例CV事件，包括80例中风和36例冠心病事件。在608例患者中（A组 = 507例无事件发生，B组 = 101例有事件发生：69例中风、26例冠心病事件、6例其他事件），平均24小时UNa为208±79mmol/天，相当于盐摄入量为12.1±4.6g/天。24小时UNa与BMI、PWV和收缩压（SBP）呈正相关，特别是与夜间SBP相关。B组与A组相比，UNa更高（260 + 98 vs. 198 + 71mmol/天，P < 0.001），PWV更高，诊室血压、24小时、白天和夜间SBP也更高。逻辑回归分析确定年龄、夜间SBP以及每增加10mmol UNa⁺[HR = 1.09（95%CI，1.06 - 1.12，P < 0.001）]为CV事件的唯一独立预测因素。UNa⁺高于中位数（189mmol钠/天）预测CV事件的HR = 2.99（95%CI，1.75 - 5.13，P < 0.001），无CV事件生存率更差（对数秩统计为17.44，P < 0.001）。