Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Japan.
Division of Nephrology, Shimane University Hospital, Izumo, Japan.
J Clin Hypertens (Greenwich). 2020 Apr;22(4):649-655. doi: 10.1111/jch.13844. Epub 2020 Mar 16.
Salt sensitivity is one of the crucial risk factors of hypertension. The aim of the present prospective cohort study was to assess the clinical impact of alcohol drinking on an association between salt intake and blood pressure. The present study included 451 employees at a pharmaceutical company in Japan who underwent annual health checkups in both 2017 and 2018. The main exposure of interest was self-reported drinking frequency at their first checkups: rarely, occasionally, and daily. To assess the association between the change of salt intake estimated from single-spot urine specimens and that of blood pressure, the differences in systolic/diastolic blood pressure and salt intake between 2017 and 2018 were calculated for each subject. Multivariable-adjusted linear regression models adjusting for clinically relevant factors clarified a drinking frequency-dependent association between Δsalt intake and Δsystolic blood pressure (per 1 g/d of Δsalt intake adjusted β [95% confidence interval] 0.19 [-0.73, 1.12], 0.84 [0.14, 1.53], and 1.78 [0.86, 2.69] in rare, occasional, and daily drinkers). A similar association between Δsalt intake and Δdiastolic blood pressure was also observed (-0.24 [-1.02, 0.54], 0.67 (0.18, 1.16), 0.95 [0.38, 1.51], in rare, occasional, and daily drinkers). The interactions between drinking frequency and Δsalt intake were found to be statistically significant (P for interaction = .028 and .006 for ∆systolic blood pressure and ∆diastolic blood pressure, respectively). The present study identified enhanced salt sensitivity in the subjects who drink at a higher frequency, suggesting that the reduction in alcohol consumption may improve salt sensitivity in higher frequency drinkers.
盐敏感性是高血压的关键危险因素之一。本前瞻性队列研究旨在评估饮酒频率对盐摄入量与血压之间关联的临床影响。本研究纳入了日本一家制药公司的 451 名员工，他们在 2017 年和 2018 年都接受了年度健康检查。主要暴露因素为他们首次检查时的饮酒频率：很少、偶尔和每天。为了评估从单份尿样估计的盐摄入量变化与血压变化之间的关联，计算了每个受试者的收缩压/舒张压和盐摄入量在 2017 年和 2018 年之间的差异。多变量调整的线性回归模型，调整了临床相关因素，明确了盐摄入量变化与收缩压变化之间的饮酒频率依赖性关联（每 1 g/d 的盐摄入量变化调整β[95%置信区间]0.19[-0.73, 1.12]、0.84[0.14, 1.53]和 1.78[0.86, 2.69]在很少、偶尔和每天饮酒者中）。盐摄入量变化与舒张压变化之间也观察到类似的关联（-0.24[-1.02, 0.54]、0.67（0.18, 1.16）、0.95[0.38, 1.51]在很少、偶尔和每天饮酒者中）。饮酒频率和盐摄入量变化之间的交互作用具有统计学意义（收缩压和舒张压的交互作用 P 值分别为.028 和.006）。本研究发现，饮酒频率较高的受试者盐敏感性增强，提示减少饮酒可能会改善高频率饮酒者的盐敏感性。
