Guo Tong-Shuai, Dai Yi, Ren Ke-Yu, Mu Jian-Jun, Ren Jie, Wang Dan, Wang Yang, Chu Chao, Li Yan, Yuan Zu-Yi
aDepartment of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University bNational Health and Family Planning Commission of Shaanxi, Xi'an cShanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Blood Press Monit. 2017 Dec;22(6):307-313. doi: 10.1097/MBP.0000000000000276.
Salt-sensitive (SS) patients more frequently showed a nondipper blood pressure pattern and were associated with more serious target organ damage than non-SS patients. We aimed to investigate whether potassium supplement can improve the blunted nocturnal blood pressure fall in SS patients exposed to a high-salt diet.
Approximately 49 normotensive and mildly hypertensive Chinese patients received a study protocol of a 3 days of baseline examination, 7 days of a low-salt diet (3 g NaCl/day), 7 days of a high-salt diet (18 g NaCl/day), and 7 days of a high-salt diet with a potassium supplement (18 g NaCl and 4.5 g KCl/day). The 24 h ambulatory blood pressure was determined at the end of each period.
A total of 14 patients were classified as SS according to the at least 10% increase in their 24-h mean arterial pressure after high-salt loading. The night-to-day blood pressure ratio was significantly higher in SS patients than in non-SS patients during the high-salt loading period (systolic 0.96±0.01 vs. 0.89±0.01, P<0.01; diastolic 0.96±0.01 vs. 0.92±0.01, P<0.05). Compared with the high-salt loading period, the night-to-day blood pressure ratio was significantly reversed by potassium supplement in SS patients (systolic 0.91±0.01 vs. 0.96±0.01, P<0.05; diastolic 0.91±0.01 vs. 0.96±0.01, P<0.05).
Potassium supplement can improve the blunted nocturnal blood pressure fall in SS patients exposed to a high-salt diet, but the related mechanism needs to be studied further.
盐敏感（SS）患者比非SS患者更常出现血压非勺型模式，且与更严重的靶器官损害相关。我们旨在研究补钾是否能改善高盐饮食的SS患者夜间血压下降减弱的情况。
约49例血压正常和轻度高血压的中国患者接受了一项研究方案，包括3天的基线检查、7天的低盐饮食（3克氯化钠/天）、7天的高盐饮食（18克氯化钠/天）以及7天的高盐饮食加补钾（18克氯化钠和4.5克氯化钾/天）。在每个阶段结束时测定24小时动态血压。
根据高盐负荷后24小时平均动脉压至少升高10%，共有14例患者被归类为SS。在高盐负荷期，SS患者的夜间与日间血压比值显著高于非SS患者（收缩压0.96±0.01对0.89±0.01，P<0.01；舒张压0.96±0.01对0.92±0.01，P<0.05）。与高盐负荷期相比，补钾使SS患者的夜间与日间血压比值显著逆转（收缩压0.91±0.01对0.96±0.01，P<0.05；舒张压0.91±0.01对0.96±0.01，P<0.05）。
补钾可改善高盐饮食的SS患者夜间血压下降减弱的情况，但相关机制有待进一步研究。
