Yang Guo-Hong, Zhou Xin, Ji Wen-Jie, Liu Jun-Xiang, Sun Jing, Shi Rui, Jiang Tie-Min, Li Yu-Ming
Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin, China.
Medicine (Baltimore). 2018 Apr;97(14):e0342. doi: 10.1097/MD.0000000000010342.
Evidence has shown that long-term sodium reduction can not only reduce blood pressure, but also provide cardiovascular benefits. To date, there is little evidence related to the effects of salt reduction on isolated systolic hypertension (ISH).A total of 126 hypertensive patients were divided into an ISH group (n = 51) and a non-ISH (NISH) group (n = 75). The members of each group were then randomly assigned to low sodium salt (LSSalt) or normal salt (NSalt) diets for 6 months. Their blood pressure was measured every 2 months. Serum plasma renin-angiotensin activity, blood biochemical assays and urinary measurements were determined at the baseline and at the end of the 6 months.At the end of the study, the mean systolic blood pressure (SBP) of the ISH LSSalt group had significantly decreased by 10.18 mm Hg (95% confidence interval (CI): 3.13 to 17.2, P = .006) compared with that of the ISH NSalt group, while the mean SBP only decreased by 5.10 mm Hg (95% CI: -2.02 to 12.2, P = .158) in the NISH LSSalt group compared with that of the NISH NSalt group. The mean diastolic blood pressure (DBP) had no significant differences in the ISH and NISH groups. No obvious renin angiotensin system activation was found after LSSalt intervention. Regarding the urinary excretion of electrolytes and blood biochemical assays, the LSSalt treatment had the same effects on the ISH group as on the NISH group.The present study showed that the SBP of ISH patients was significantly decreased with the LSSalt intervention, while neither the SBP of the NISH patients nor the DBP of either group were similarly decreased, which indicated that ISH patients were more sensitive to salt restriction.
有证据表明,长期减少钠摄入不仅可以降低血压,还能带来心血管益处。迄今为止,几乎没有证据表明减盐对单纯收缩期高血压(ISH)有何影响。
总共126例高血压患者被分为ISH组(n = 51)和非ISH(NISH)组(n = 75)。然后将每组成员随机分配至低钠盐(LSSalt)或普通盐(NSalt)饮食组,为期6个月。每2个月测量一次他们的血压。在基线期和6个月末测定血清血浆肾素 - 血管紧张素活性、血液生化指标和尿液指标。
研究结束时,ISH LSSalt组的平均收缩压(SBP)与ISH NSalt组相比显著下降了10.18 mmHg(95%置信区间(CI):3.13至17.2,P = .006),而NISH LSSalt组的平均SBP与NISH NSalt组相比仅下降了5.10 mmHg(95% CI: -2.02至12.2,P = .158)。ISH组和NISH组的平均舒张压(DBP)无显著差异。LSSalt干预后未发现明显的肾素血管紧张素系统激活。关于电解质的尿排泄和血液生化指标,LSSalt治疗对ISH组和NISH组的影响相同。
本研究表明,LSSalt干预使ISH患者的SBP显著下降,而NISH患者的SBP以及两组的DBP均未出现类似下降,这表明ISH患者对盐限制更为敏感。