中国高血压、正常血压和低血压成年人的血压与估计的尿钠、钾排泄及其比值的关系。

The association of blood pressure with estimated urinary sodium, potassium excretion and their ratio in hypertensive, normotensive, and hypotensive Chinese adults.

机构信息

Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China.

Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Asia Pac J Clin Nutr. 2020;29(1):101-109. doi: 10.6133/apjcn.202003_29(1).0014.

DOI:10.6133/apjcn.202003_29(1).0014

PMID:32229448

Abstract

BACKGROUND AND OBJECTIVES

Low sodium and high potassium intake is reported to be a risk of hypertension. However, it is uncertain whether these associations can be generalized to those without hypertension. This study is to evaluate the associations of systolic and diastolic blood pressure (SBP and DBP, respectively) with estimated urinary sodium excretion (eUNaE), estimated urinary potassium excretion (eUKE) and their ratio (Na/K ratio) among hypertensive, normotensive, and hypotensive Chinese individuals.

METHODS AND STUDY DESIGN

A large institution-based cross-sectional study was conducted at the Third Xiangya Hospital, Changsha between August 2017 and November 2018. Spot urine samples were collected to test urinary sodium, potassium, and creatinine excretions for each participant. The Kawasaki formula was used to estimate 24-hour urinary sodium and potassium excretions.

RESULTS

A total of 26,363 eligible subjects were used to analyze the associations of blood pressure with eUNaE, eUKE, and their ratio. 27.3% (n=7,201) of participants were diagnosed with hypertension, 5.4% (n=1,427) were diagnosed with hypotension, and the remaining of 17,735 participants were normotensive. A significant increase in SBP and DBP was related to the Na/K ratio increase in hypertensive and normotensive subgroups (all ptrend<0.01), but the association was not significant for DBP among hypotensive individuals (ptrend=0.58). Stronger associations of SBP with the Na/K ratio were observed in older people (pinteraction<0.01) and females (pinteraction<0.0001), but the same trend was not observed for DBP (pinteraction=0.10 and 0.88, respectively).

CONCLUSIONS

High potassium and low sodium intake were further confirmed to reduce blood pressure in hypotensive, normotensive, and hypertensive individuals.

摘要

背景和目的

低钠高钾的摄入据报道与高血压的风险相关。然而，这些关联是否可以推广到那些没有高血压的人群中还不确定。本研究旨在评估高血压、正常血压和低血压人群的收缩压和舒张压（分别为 SBP 和 DBP）与估计的尿钠排泄量（eUNaE）、估计的尿钾排泄量（eUKE）及其比值（Na/K 比值）之间的关系。

方法和研究设计

这是一项于 2017 年 8 月至 2018 年 11 月在长沙湘雅三医院进行的大型机构间横断面研究。收集每位参与者的尿液样本，以检测尿钠、钾和肌酐的排泄量。采用川崎公式估计 24 小时尿钠和钾的排泄量。

结果

共有 26363 名符合条件的参与者被纳入分析血压与 eUNaE、eUKE 和其比值之间的关系。27.3%（n=7201）的参与者被诊断为高血压，5.4%（n=1427）的参与者被诊断为低血压，其余 17735 名参与者为正常血压。在高血压和正常血压亚组中，SBP 和 DBP 的升高与 Na/K 比值的升高呈显著相关（均 ptrend<0.01），但在低血压人群中，这种相关性不显著（ptrend=0.58）。SBP 与 Na/K 比值的相关性在老年人（pinteraction<0.01）和女性（pinteraction<0.0001）中更强，但 DBP 没有这种趋势（pinteraction=0.10 和 0.88，分别）。