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中心动脉压对膳食钠钾干预的反应。

Central Blood Pressure Responses to Dietary Sodium and Potassium Interventions.

机构信息

Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, China.

Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, China.

出版信息

Am J Hypertens. 2018 Apr 13;31(5):582-589. doi: 10.1093/ajh/hpx209.

Abstract

BACKGROUND

To explore how central hemodynamics respond to dietary sodium and potassium interventions, and whether the responses are associated with metabolic traits.

METHODS

We conducted a dietary intervention study including a 7-day low-sodium (51.3 mmol sodium/day) intervention, a 7-day high-sodium (307.8 mmol sodium/day) intervention, and a 7-day high-sodium with potassium supplementation (60.0 mmol potassium/day) intervention among 99 northern Chinese subjects aged 18-60 years. Five metabolic traits included abdominal obesity, high triglycerides, low HDL cholesterol, raised blood pressure (BP), and high glucose. Central hemodynamics were measured at baseline and during each intervention.

RESULTS

Central systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), and augmentation index (AIx@75) significantly decreased during low-sodium intervention, increased during high-sodium intervention, and then decreased during potassium supplementation. We observed potential linear trends toward significance of central SBP and PP responses to low-sodium intervention, and significant linear trends of responses to high-sodium intervention as the number of metabolic traits grows. For example, among participants with 0 or 1, 2 or 3, and 4 or 5 metabolic traits, central SBP responses to high-sodium intervention were 8.8 [95% confidence interval (5.8, 11.8)], 9.3 (7.1, 11.6), and 14.0 (11.6, 16.3) mmHg, respectively (P for trend = 0.009). Significant linear trends of central SBP and DBP responses to potassium supplementation were also observed.

CONCLUSIONS

Central BP and AIx@75 were lowered by sodium reduction and potassium supplementation, and elevated by sodium-loading. The responses of central BP were pronounced among individuals with metabolic traits clustering.

CLINICAL TRIALS REGISTRATION

Trial Number NCT00721721 (The current study is registered on ClinicalTrials.gov; https://clinicaltrials.gov).

摘要

背景

探讨中心血流动力学对饮食钠钾干预的反应,以及这些反应是否与代谢特征有关。

方法

我们进行了一项饮食干预研究,包括 99 名年龄在 18-60 岁的中国北方人进行为期 7 天的低钠(51.3mmol 钠/天)干预、7 天的高钠(307.8mmol 钠/天)干预和 7 天的高钠补钾(60.0mmol 钾/天)干预。五种代谢特征包括腹部肥胖、高甘油三酯、低高密度脂蛋白胆固醇、血压升高和高血糖。在基线和每个干预期间测量中心血流动力学。

结果

中心收缩压(SBP)、舒张压(DBP)、脉压(PP)和增强指数(AIx@75)在低钠干预期间显著下降,在高钠干预期间升高,然后在补钾期间下降。我们观察到中心 SBP 和 PP 对低钠干预的反应呈潜在线性趋势,随着代谢特征数量的增加,对高钠干预的反应呈显著线性趋势。例如,在有 0 或 1、2 或 3、4 或 5 种代谢特征的参与者中,高钠干预时中心 SBP 的反应分别为 8.8[95%置信区间(5.8,11.8)]、9.3(7.1,11.6)和 14.0(11.6,16.3)mmHg(趋势 P 值=0.009)。还观察到中心 SBP 和 DBP 对补钾的反应呈显著线性趋势。

结论

中心 SBP 和 AIx@75 通过减少钠和补充钾而降低,通过增加钠负荷而升高。在代谢特征聚集的个体中,中心 SBP 的反应更为明显。

临床试验注册

试验编号 NCT00721721(本研究在 ClinicalTrials.gov 上注册;https://clinicaltrials.gov)。

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