Pereira Taísa Sabrina Silva, Mill José Geraldo, Griep Rosane Harter, Sichieri Rosely, Molina Maria Del Carmen Bisi
Department of Health Sciences, University of the Americas Puebla, Puebla, México.
Post Graduate Programme in Public Health, Federal University of Espírito Santo, Espírito Santo.
Medicine (Baltimore). 2019 Jul;98(28):e16278. doi: 10.1097/MD.0000000000016278.
To assess the effect of changing the sodium to potassium (Na/K) ratio on blood pressure at 4 years of follow-up.The measurements were carried out under identical conditions in two study periods (2008-2010 and 2012-2014). Urinary excretion of sodium and potassium (mmol/L) over 12 nocturnal hours was used to calculate the Na/K ratio and categorized by quintile. The 24-hour sodium and potassium intake was estimated using a validated equation. The mean BP was calculated from 3 measurements after 5 minutes of rest. Of the 15,105 participants at baseline, 14,014 completed the first follow-up. Participants without validated urine collection (n = 5,041), using antihypertensive medication (n = 3,860) at either time points or reporting bariatric surgery during follow-up (n = 45) were excluded. The differences between follow-up and baseline values were calculated for BP and the Na/K ratio. Analyses were stratified by sex and adjusted for confounding variables.Sodium intake did not change from baseline, but potassium intake increased by approximately 150 mg in both sexes (P < .001), with a consequent reduction of the Na/K ratio. The highest quintile of change in the Na/K ratio was associated with greater variation in BP. When adjusted for covariates, it is possible to observe an increase in SBP in women from the third quintile of the Na/K ratio, in men this increase was observed from the fourth quintile. However, for DBP this increase is observed from the third quintile in both men and women.Increase in SBP was observed in women from the third quintile of the Na/K ratio, in men this increase is observed from the fourth quintile. However, for DBP this increase is observed from the third quintile in both men and women. The Na/K ratio demonstrated a greater association in BP.
为评估在4年随访期内改变钠钾（Na/K）比值对血压的影响。测量在两个研究阶段（2008 - 2010年和2012 - 2014年）的相同条件下进行。采用12个夜间小时的尿钠和尿钾排泄量（mmol/L）来计算Na/K比值，并按五分位数进行分类。使用经过验证的方程估算24小时钠和钾摄入量。休息5分钟后通过3次测量计算平均血压。在15105名基线参与者中，14014人完成了首次随访。排除未经验证的尿液收集者（n = 5041）、在任一时间段使用降压药物者（n = 3860）或在随访期间报告接受减重手术者（n = 45）。计算随访值与基线值之间血压和Na/K比值的差异。分析按性别分层，并对混杂变量进行校正。钠摄入量与基线相比未发生变化，但男女钾摄入量均增加了约150mg（P <.001），从而导致Na/K比值降低。Na/K比值变化的最高五分位数与血压的更大变化相关。在对协变量进行校正后，可以观察到女性从Na/K比值的第三个五分位数开始收缩压升高，男性从第四个五分位数开始出现这种升高。然而，对于舒张压，男性和女性均从第三个五分位数开始出现升高。女性从Na/K比值的第三个五分位数开始观察到收缩压升高，男性从第四个五分位数开始观察到这种升高。然而，对于舒张压，男性和女性均从第三个五分位数开始观察到升高。Na/K比值在血压方面表现出更强的相关性。
