Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang-si, Korea.
Division of Cardiology, Hallym University Sacred Heart Hospital/Hallym University College of Medicine, Anyang-si, Korea.
J Clin Hypertens (Greenwich). 2019 Aug;21(8):1057-1062. doi: 10.1111/jch.13610. Epub 2019 Jun 27.
The objective of this study was to evaluate the association between sodium intake and blood pressure (BP) control in hypertensive patients taking antihypertensive medications by using 24-hour urine collection and 24-hour ambulatory BP. This is a cross-sectional community-based study and conducted in 2011 and 2012. A total of 1128 participants were recruited from five cities in Korea. Among them, 740 participants who had complete 24-hour urine collection and valid 24-hour ambulatory BP data were included in this study. Participants were divided into four groups: normotensives (NT, n = 441), untreated hypertensive patients (UTHT, n = 174), controlled hypertensive patients (CHT, n = 62), and uncontrolled hypertensive patients (UCHT, n = 63). UCHT and CHT groups showed higher mean age than NT and UTHT groups. UCHT and UTHT groups showed higher 24-hour systolic BP (SBP) and diastolic BP (DBP) than NT and CHT groups. UCHT group had the highest level of 24-hour urine sodium. Multivariate analysis adjusted with age, gender, body mass index, estimated glomerular filtration rate, and use of diuretics showed higher level of 24-hour urine sodium in UCHT group than that in CHT group. Multivariate logistic regression analysis revealed independent association of the amount of 24-hour urine sodium with uncontrolled BP in hypertensive patients on antihypertensive drug treatment. Higher level of 24-hour urine sodium excretion in uncontrolled hypertensive patients suggests that excessive sodium intake could be associated with blunted BP lowering efficacy of antihypertensive medications.
本研究旨在通过 24 小时尿液收集和 24 小时动态血压监测评估高血压患者的钠摄入量与血压控制之间的关系。这是一项基于社区的横断面研究，于 2011 年和 2012 年进行。共从韩国五个城市招募了 1128 名参与者。其中，740 名完成了 24 小时尿液收集和有效的 24 小时动态血压数据的参与者被纳入本研究。参与者被分为四组：血压正常者（NT，n=441）、未治疗的高血压患者（UTHT，n=174）、血压控制良好的高血压患者（CHT，n=62）和血压控制不佳的高血压患者（UCHT，n=63）。UCHT 和 CHT 组的平均年龄高于 NT 和 UTHT 组。UCHT 和 UTHT 组的 24 小时收缩压（SBP）和舒张压（DBP）均高于 NT 和 CHT 组。UCHT 组的 24 小时尿钠水平最高。调整年龄、性别、体重指数、估算肾小球滤过率和利尿剂使用情况的多变量分析显示，UCHT 组的 24 小时尿钠水平高于 CHT 组。多变量逻辑回归分析显示，高血压患者在服用抗高血压药物治疗时，24 小时尿钠量与血压控制不佳独立相关。血压控制不佳的高血压患者 24 小时尿钠排泄量较高提示，钠摄入过多可能与抗高血压药物降低血压的疗效减弱有关。
