Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
Am J Hypertens. 2018 Jun 11;31(7):784-791. doi: 10.1093/ajh/hpy031.
While the positive relationship between urinary sodium excretion and blood pressure (BP) is well established for middle-aged to elderly individuals using office BP, data are limited for younger individuals and ambulatory BP measurements.
Our analysis included 2,899 individuals aged 18 to 90 years from 2 population-based studies (GAPP, Swiss Kidney Project on Genes in Hypertension [SKIPOGH]). Participants with prevalent cardiovascular disease, diabetes, or on BP-lowering treatment were excluded. In SKIPOGH, 24-hour urinary sodium excretion was used as a measure of sodium intake, while in GAPP it was calculated from fasting morning urinary samples using the Kawasaki formula. Multivariable linear regression models were used to assess the relationships of 24-hour urinary salt excretion with office and ambulatory BP measurements.
Mean age, ambulatory BP, sodium excretion, and estimated glomerular filtration rate in GAPP and SKIPOGH were 35 and 44 years, 123/78 and 118/77 mm Hg, 4.2 and 3.3 g/d, and 110 and 99 ml/min/1.73 m2, respectively. A weak linear association was observed between 24-hour ambulatory systolic BP and urinary sodium excretion (β (95% confidence interval [CI]) per 1 g increase in sodium excretion (0.33 % (0.09; 0.57); P = 0.008). No significant relationships were observed for 24-hour ambulatory diastolic BP (β (95% CI) (0.13 % (-0.15; 0.40) P = 0.37). When repeating the analyses in different age groups, all BP indices appeared to have stronger relationships in the older age groups (>40 years).
In these large cohorts of healthy adults, urinary sodium excretion was only weakly associated with systolic 24-hour ambulatory BP.
虽然使用办公血压（BP）测量已确定中年至老年个体的尿钠排泄与血压（BP）之间存在正相关关系，但针对年轻个体和动态血压测量的数据有限。
我们的分析包括来自 2 项基于人群的研究（GAPP、瑞士高血压基因研究项目 [SKIPOGH]）的 2899 名年龄在 18 至 90 岁的个体。排除有心血管疾病、糖尿病或正在服用降压药物的患者。在 SKIPOGH 中，24 小时尿钠排泄被用作钠摄入量的测量指标，而在 GAPP 中，它是根据空腹晨尿尿样使用川崎公式计算得出的。使用多变量线性回归模型评估 24 小时尿盐排泄与办公血压和动态血压测量之间的关系。
GAPP 和 SKIPOGH 的平均年龄、动态血压、钠排泄和估计肾小球滤过率分别为 35 岁和 44 岁、123/78mmHg 和 118/77mmHg、4.2g/d 和 3.3g/d、110ml/min/1.73m2 和 99ml/min/1.73m2。24 小时动态收缩压与尿钠排泄之间存在较弱的线性关联（每增加 1g 钠排泄，β（95%置信区间[CI]）为 0.33%（0.09；0.57）；P=0.008）。24 小时动态舒张压没有观察到显著的相关性（β（95%CI）（0.13%（-0.15；0.40）；P=0.37）。当在不同年龄组中重复分析时，所有 BP 指数在年龄较大的组（>40 岁）中似乎与更强的关系。
在这些大型健康成年人队列中，尿钠排泄仅与 24 小时动态收缩压呈弱相关。
