Mohammadifard Noushin, Khaledifar Arsalan, Khosravi Alireza, Nouri Fatemeh, Pourmoghadas Ali, Feizi Awat, Esmaillzadeh Ahmad, Sarrafzadegan Nizal
Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Isfahan, Shahrekord, Iran.
Hypertension Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Shahrekord, Iran.
Nutr Diet. 2017 Jul;74(3):275-282. doi: 10.1111/1747-0080.12304. Epub 2016 Sep 7.
The association of sodium (Na) and potassium (K) intake with blood pressure (BP) is an ongoing debate, especially in central Iran. We aimed to examine the mean Na and K intake, major sources of Na and the relationship between BP and dietary and urinary Na and K.
This cross-sectional study was performed in central Iran in 2013-2014. A total of 796 non-hypertensive adults aged >18 years were randomly recruited. The semi-quantitative food frequency questionnaire was used to assess dietary Na and K intake. Moreover, 24-hour urine samples were collected to measure 24-hour urinary Na (UNa) and K (UK) as biomarkers. BP was measured twice on each arm using a standard protocol.
The mean Na and K intake were 4309.6 ± 1344.4 and 2732.7 ± 1050.5 mg/day, respectively. Table and cooking salt were the main sources of Na. Odds ratio (OR) (95% confidence interval (CI)) of the crude model in the highest quartile of UNa indicated a significant association with the higher risk of prehypertension (OR (95% CI): 2.09 (1.09-4.05); P for trend = 0.007). After adjustment for potential confounders, prehypertension was significantly associated with increasing dietary Na/K ratio (OR (95% CI): 1.28 (1.01-1.57); P for trend = 0.046) and UNa/UK ratio (OR (95% CI): 2.15(1.08-4.55); P for trend = 0.029).
Increasing dietary and urinary Na/K ratios and UNa were associated with elevated BP and prehypertension occurrence. These findings support the necessity of developing a salt reduction programme in our country.
钠（Na）和钾（K）摄入量与血压（BP）之间的关联一直存在争议，尤其是在伊朗中部地区。我们旨在研究钠和钾的平均摄入量、钠的主要来源以及血压与膳食和尿钠、钾之间的关系。
这项横断面研究于2013 - 2014年在伊朗中部进行。共随机招募了796名年龄大于18岁的非高血压成年人。采用半定量食物频率问卷评估膳食钠和钾的摄入量。此外，收集24小时尿液样本以测量24小时尿钠（UNa）和钾（UK）作为生物标志物。使用标准方案在每个手臂上测量两次血压。
钠和钾的平均摄入量分别为4309.6±1344.4和2732.7±1050.5毫克/天。餐桌盐和烹饪盐是钠的主要来源。在最高四分位数的尿钠中，粗模型的优势比（OR）（95%置信区间（CI））表明与高血压前期风险较高显著相关（OR（95%CI）：2.09（1.09 - 4.05）；趋势P值 = 0.007）。在调整潜在混杂因素后，高血压前期与膳食钠/钾比值增加（OR（95%CI）：1.28（1.01 - 1.57）；趋势P值 = 0.046）和尿钠/尿钾比值（OR（95%CI）：2.15（1.08 - 4.55）；趋势P值 = 0.029）显著相关。
膳食和尿钠/钾比值以及尿钠增加与血压升高和高血压前期的发生有关。这些发现支持在我国开展减盐计划的必要性。
