Xu Jianwei, Chen Xiaorong, Ge Zeng, Liang Hao, Yan Liuxia, Guo Xiaolei, Zhang Yongqing, Wang Linhong, Ma Jixiang
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Shandong Center for Disease Control and Prevention, Jinan, China.
Kidney Blood Press Res. 2017;42(1):188-200. doi: 10.1159/000475486. Epub 2017 Apr 25.
BACKGROUND/AIMS: High sodium intake and low intake of potassium can increase blood pressure (BP) and risk of developing hypertension. Few studies have examined the association between 24-h urinary sodium and potassium excretion and BP or risk of hypertension in China, and most used only a single 24-h urinary sample.
We analyzed data on 2281 participants aged 18-69 years by using two 24-h urinary sodium and potassium excretions from the supplemental baseline survey of the Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH) project. We used measurement error models to estimate usual intakes, multivariable linear regression to assess their association with B P, and logistic regression to estimate the risk of hypertension.
The average usual intakes of sodium and potassium, and the mean sodium-potassium ratio, were 166.9 mmol/day, 25.3 mmol/day, and 6.8, respectively. All three measures were significantly associated with systolic BP (SBP) and diastolic BP (DBP), with an increase of 1.39 mmHg (95% confidence interval [CI] 0.44─2.34) in SBP and 0.94 mmHg (95% CI 0.34─1.55) in DBP for a 1-standard deviation (SD) (25.6mmol/day) increase in sodium intake, a decrease of 1.42 mmHg (95% CI -2.37─ -0.47) in SBP and 0.91 mmHg (95% CI -1.52─ -0.30) in DBP for a 1-SD (3.4 mmol/day) increase in potassium intake, and an increase of 0.97 mmHg (95% CI 0.36─1.58) in SBP and of 0.65 mmHg (95% CI 0.26─1.04) in DBP per unit increase in the sodium-to-potassium ratio. The adjusted odds ratios comparing the risk of hypertension among adults in the highest with those in the lowest quintile differ significantly for potassium (0.51; 95% CI 0.29─0.88) and sodium-to-potassium ratio (1.40; 95% CI 1.01─1.94).
Our results suggested that higher sodium and lower potassium intakes are associated with increased BP and risk of hypertension in the Shandong and Jiangsu adults.
背景/目的：高钠摄入和低钾摄入会升高血压（BP）并增加患高血压的风险。在中国，很少有研究探讨24小时尿钠和钾排泄与血压或高血压风险之间的关联，并且大多数研究仅使用单次24小时尿样。
我们通过使用来自山东-卫生部减盐与高血压行动（SMASH）项目补充基线调查的两次24小时尿钠和钾排泄数据，对2281名年龄在18 - 69岁的参与者进行了分析。我们使用测量误差模型来估计通常摄入量，使用多变量线性回归来评估它们与血压的关联，并使用逻辑回归来估计患高血压的风险。
钠、钾的平均通常摄入量以及钠钾比分别为166.9 mmol/天、25.3 mmol/天和6.8。所有这三项指标均与收缩压（SBP）和舒张压（DBP）显著相关，钠摄入量每增加1个标准差（SD）（25.6 mmol/天），SBP升高1.39 mmHg（95%置信区间[CI] 0.44─2.34），DBP升高0.94 mmHg（95% CI 0.34─1.55）；钾摄入量每增加1个SD（3.4 mmol/天），SBP降低1.42 mmHg（95% CI -2.37─ -0.47），DBP降低0.91 mmHg（95% CI -1.52─ -0.30）；钠钾比每增加一个单位，SBP升高0.97 mmHg（95% CI 0.36─1.58），DBP升高0.65 mmHg（95% CI 0.26─1.04）。将最高五分位数与最低五分位数的成年人患高血压风险进行比较，调整后的优势比在钾（0.51；95% CI 0.29─0.88）和钠钾比（1.40；95% CI 1.01─1.94）方面有显著差异。
我们的结果表明，较高的钠摄入量和较低的钾摄入量与山东和江苏成年人血压升高及高血压风险增加有关。
