Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.
Hypertens Res. 2022 Feb;45(2):354-359. doi: 10.1038/s41440-021-00797-w. Epub 2021 Nov 10.
This study aimed to investigate the cross-sectional association between serum sodium and blood pressure at baseline and, more importantly, investigate the prospective association between serum sodium and the risk of incident hypertension. We used data from 1 638 workers aged 18 to 71 years who participated in 2015-2016 survey of the Furukawa Nutrition and Health Study. During a maximum follow-up of 3 years, 229 participants developed hypertension. Multivariable linear regression models were used to evaluate the cross-sectional association. The Cox proportional hazards model was used to calculate the hazard ratio and 95% confidence interval of incident hypertension across quartiles of serum sodium (137-140, 141-142, 143, and 144-147 mmol/L). In the cross-sectional analysis, we did not observe a significant association between serum sodium and blood pressure at baseline. In the prospective analysis, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident hypertension were 1.03 (0.71-1.51), 1.35 (0.87-2.08), and 1.46 (0.97-2.20) for the upper three quartiles of the serum sodium levels compared with the lowest quartile (P for trend=0.02). When serum sodium was treated as a continuous variable, the multivariable-adjusted hazard ratio for hypertension was 1.10 (1.03-1.18). The association was slightly attenuated after additionally adjusting for baseline blood pressure, with a hazard ratio of 1.08 (1.00-1.16) for a 1 mmol/L increase in serum sodium. In conclusion, an elevated serum sodium level was associated with an increased risk of developing hypertension, suggesting that serum sodium could be a potential risk factor for hypertension.
本研究旨在探讨基线时血清钠与血压的横断面关联，更重要的是，探讨血清钠与高血压发病风险的前瞻性关联。我们使用了参加 2015-2016 年福川营养与健康研究的 18 至 71 岁的 1638 名工人的数据。在最长 3 年的随访期间，有 229 名参与者发生了高血压。多变量线性回归模型用于评估横断面关联。Cox 比例风险模型用于计算血清钠四分位数（137-140、141-142、143 和 144-147mmol/L）之间高血压发病的风险比和 95%置信区间。在横断面分析中，我们没有观察到基线时血清钠与血压之间存在显著关联。在前瞻性分析中，多变量调整后的高血压发病风险比（95%置信区间）分别为血清钠水平较高的三个四分位数与最低四分位数相比为 1.03（0.71-1.51）、1.35（0.87-2.08）和 1.46（0.97-2.20）（趋势 P=0.02）。当血清钠作为连续变量处理时，高血压的多变量调整风险比为 1.10（1.03-1.18）。另外调整基线血压后，关联略有减弱，血清钠增加 1mmol/L 的风险比为 1.08（1.00-1.16）。综上所述，血清钠水平升高与高血压发病风险增加相关，表明血清钠可能是高血压的潜在危险因素。
