Kaddumukasa Martin N, Katabira Elly, Sajatovic Martha, Pundik Svetlana, Kaddumukasa Mark, Goldstein Larry B
From the Department of Internal Medicine (M.N.K., E.K., M.K.), Makerere University, College of Health Sciences, Kampala, Uganda; Neurological and Behavioral Outcomes Center (M.S.), University Hospitals Case Medical Center, Cleveland; School of Medicine (S.P.), Cleveland VA Medical Center and Case Western Reserve University, Cleveland, OH; and Department of Neurology (L.B.G.), University of Kentucky, Lexington.
Neurology. 2016 Sep 20;87(12):1198-205. doi: 10.1212/WNL.0000000000003117. Epub 2016 Aug 24.
We assessed 24-hour urine sodium levels as an index of dietary salt consumption and its association with dietary salt knowledge and hypertension among poststroke patients with and without a history of hypertension in Uganda.
A case-control study in which poststroke patients with a history of hypertension (cases, n = 123) were compared to poststroke patients without known hypertension (controls, n = 112). Dietary salt intake was assessed by 24-hour urine sodium, a valid measure of dietary salt consumption. Dietary salt knowledge was determined by questionnaire. The independent relationships among salt knowledge, 24-hour urine sodium, and blood pressure control were assessed using multiple regression analysis.
High 24-hour urine sodium (≥8.5 g/d) was 2 times more prevalent among hypertensive poststroke patients than controls (p = 0.002). Patients with minimal poststroke disability who had a choice in determining their diets had higher urine sodium than their more disabled counterparts. Only 43% of the study population had basic dietary salt knowledge, 39% had adequate diet-disease-related knowledge, and 37% had procedural knowledge (report of specific steps being taken to reduce salt consumption). Dietary salt knowledge was similarly poor among cases and controls (p = 0.488) and was not related to education level (p = 0.205).
High urine sodium and high salt-diet preferences were more frequent among poststroke hypertensive patients in Uganda than in their nonhypertensive counterparts. There was, however, no difference in dietary salt knowledge between these groups. The development of educational strategies that include salt-diet preferences may lead to better blood pressure control in this high-risk population.
我们评估了24小时尿钠水平，将其作为饮食中盐摄入量的指标，并研究其与乌干达有或无高血压病史的中风后患者的饮食盐知识及高血压之间的关联。
一项病例对照研究，将有高血压病史的中风后患者（病例组，n = 123）与无已知高血压的中风后患者（对照组，n = 112）进行比较。通过24小时尿钠评估饮食盐摄入量，这是一种有效的饮食盐消耗测量方法。通过问卷调查确定饮食盐知识。使用多元回归分析评估盐知识、24小时尿钠和血压控制之间的独立关系。
高血压中风后患者中24小时尿钠水平高（≥8.5 g/d）的情况比对照组普遍两倍（p = 0.002）。在饮食选择上有自主权的轻度中风后残疾患者的尿钠水平高于残疾程度更高的患者。研究人群中只有43%具备基本的饮食盐知识，39%具备与饮食-疾病相关的充分知识，37%具备程序知识（报告采取的减少盐消耗的具体步骤）。病例组和对照组的饮食盐知识同样较差（p = 0.488），且与教育水平无关（p = 0.205）。
在乌干达，中风后高血压患者中高尿钠和高盐饮食偏好比无高血压的患者更常见。然而，这些组之间的饮食盐知识没有差异。制定包括盐饮食偏好的教育策略可能会使这一高危人群的血压得到更好的控制。
