Han W, Hu Y, Tang Y, Xue F, Hou L, Liang S, Zhang B, Wang W, Asaiti K, Pang H, Wang Z, Wang Y, Zhang M, Jiang J
Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences/School of Basic Medicine Peking Union Medical College, Beijing, China.
The People's Hospital of Altay Prefecture, Xinjiang, China.
J Hum Hypertens. 2017 May;31(5):333-340. doi: 10.1038/jhh.2016.83. Epub 2017 Jan 5.
Urinary sodium levels are reported to be associated with blood pressure in clinical trials and epidemiology studies. Nevertheless, the public health message of reducing sodium intake in free-living community populations remains under debate. Based on an ongoing prospective study initiated in 2012 with a community-based design in Xinjiang, China, 1668 adults (⩾30 years old) were assessed in the current study for associations between urinary sodium and blood pressure and hypertension in a free-living population of Kazakh people. After excluding 223 people on antihypertensive medication, 1445 participants were analyzed. Second urine samples after waking were used to estimate 24-h urinary sodium excretion, which is a marker for sodium intake. Following analyses, we found that the distribution of systolic and diastolic blood pressures moved upward with increasing quartiles of urinary sodium. After adjusting for age, differences in median systolic blood pressure were 8.5 mm Hg for men and 8.0 mm Hg for women between the top and bottom urinary sodium quartiles, and differences for diastolic blood pressure were 4.7 mm Hg for men and 4.3 mm Hg for women. A significant increased risk for hypertension was observed for the top quartile of urinary sodium after adjusting for age, body mass index, smoking, alcohol consumption, fruit and vegetable consumption, with corresponding odds ratios being 1.61 (95% confidence interval (CI): 1.02-2.54) for men and 1.92 (95% CI: 1.13-3.27) for women. Improving education about reducing salt intake is of particular public importance to reduce blood pressure and the risk for hypertension among the Kazakh people.
在临床试验和流行病学研究中，尿钠水平被报告与血压有关。然而，在自由生活的社区人群中减少钠摄入的公共卫生信息仍存在争议。基于2012年在中国新疆启动的一项基于社区设计的正在进行的前瞻性研究，在本研究中对1668名成年人（≥30岁）进行了评估，以探讨哈萨克族自由生活人群中尿钠与血压及高血压之间的关联。在排除223名正在服用抗高血压药物的人后，对1445名参与者进行了分析。醒后第二次尿液样本用于估计24小时尿钠排泄量，这是钠摄入的一个指标。经过分析，我们发现收缩压和舒张压的分布随着尿钠四分位数的增加而上升。在调整年龄后，尿钠最高和最低四分位数之间，男性收缩压中位数差异为8.5mmHg，女性为8.0mmHg；舒张压差异男性为4.7mmHg，女性为4.3mmHg。在调整年龄、体重指数、吸烟、饮酒、水果和蔬菜摄入量后，尿钠最高四分位数的人群患高血压的风险显著增加，男性相应的优势比为1.61（95%置信区间（CI）：1.02 - 2.54），女性为1.92（95%CI：1.13 - 3.27）。提高关于减少盐摄入的教育对降低哈萨克族人群的血压和高血压风险具有特别重要的公共意义。
