Wang Chi, Liu Tong-Bo, Mu Lei, Wang Miao, Li Yao, Yao Si-Yu, Zhao Mao-Xiang, Xue Hao
Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
Medical Big Data Center, Chinese PLA General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2020 May 5;133(9):1066-1072. doi: 10.1097/CM9.0000000000000740.
The association between dietary sodium intake and blood pressure variability (BPV) in hypertensive patients remains unclear. The objective of this study was to demonstrate whether dietary sodium intake is a predictor of elevated BPV in Chinese patients with hypertension.
A total of 235 patients with essential hypertension were enrolled in the Department of Cardiology, Chinese People's Liberation Army (PLA) General Hospital in 2018 to 2019, all of whom underwent 24-h ambulatory blood pressure monitoring. BPV was calculated as the standard deviation (SD), coefficient of variation (CV), variation independent of mean (VIM) of blood pressure measurements, respectively, and divided into diurnal systolic BPV (SBPV), diurnal diastolic BPV (DBPV), nocturnal SBPV, and nocturnal DBPV. 24-h urine samples were collected to measure 24-h urine sodium excretion, which represents dietary sodium intake. The relationship between dietary sodium intake and BPV was analyzed by using Spearman correlations and multiple linear regression analysis.
Nocturnal SBPV-SD, CV, VIM, and nocturnal DBPV-SD in the high urine sodium excretion group were significantly higher than those in the medium and low urine sodium excretion groups, whereas diurnal SBPV-SD, CV, VIM, diurnal DBPV-SD, CV, VIM, and nocturnal DBPV-CV, VIM were not. Using the Spearman correlation analysis, we found a linear correlation between 24-h urine sodium excretion and nocturnal SBPV-SD, CV, VIM (SD, r = 0.22, P = 0.001; CV, r = 0.17, P = 0.009; VIM, r = 0.16, P = 0.020), nocturnal DBPV-SD (r = 0.21, P = 0.001), respectively. After further adjusting for confounding factors by multiple linear regression, the positive correlations remained between 24-h urine sodium excretion and nocturnal SBPV-SD, CV, VIM (SD, β = 0.224, P < 0.001; CV, β = 0.211, P = 0.001; VIM, β = 0.213, P = 0.001), nocturnal DBPV (SD, β = 0.215, P = 0.001), respectively.
Dietary sodium intake is associated with nocturnal SBPV in Chinese patients with hypertension.
高血压患者饮食中钠摄入量与血压变异性（BPV）之间的关联尚不清楚。本研究的目的是证实饮食中钠摄入量是否为中国高血压患者BPV升高的一个预测因素。
2018年至2019年，中国人民解放军总医院心内科共纳入235例原发性高血压患者，所有患者均接受24小时动态血压监测。BPV分别计算为血压测量值的标准差（SD）、变异系数（CV）、独立于均值的变异（VIM），并分为日间收缩压BPV（SBPV）、日间舒张压BPV（DBPV）、夜间SBPV和夜间DBPV。收集24小时尿液样本以测量24小时尿钠排泄量，其代表饮食中钠摄入量。采用Spearman相关性分析和多元线性回归分析饮食中钠摄入量与BPV之间的关系。
高尿钠排泄组的夜间SBPV-SD、CV、VIM以及夜间DBPV-SD显著高于中、低尿钠排泄组，而日间SBPV-SD、CV、VIM、日间DBPV-SD、CV、VIM以及夜间DBPV-CV、VIM则不然。通过Spearman相关性分析，我们发现24小时尿钠排泄量与夜间SBPV-SD、CV、VIM（SD，r = 0.22，P = 0.001；CV，r = 0.17，P = 0.009；VIM，r = 0.16，P = 0.020）、夜间DBPV-SD（r = 0.21，P = 0.001）之间分别存在线性相关性。通过多元线性回归进一步校正混杂因素后，24小时尿钠排泄量与夜间SBPV-SD、CV、VIM（SD，β = 0.224，P < 0.001；CV，β = 0.211，P = 0.001；VIM，β = 0.213，P = 0.001）、夜间DBPV（SD，β = 0.215，P = 0.001）之间仍存在正相关。
中国高血压患者饮食中钠摄入量与夜间SBPV相关。
