Department of Chronic Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou, 310051, China.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China.
Sci Rep. 2022 Aug 16;12(1):13901. doi: 10.1038/s41598-022-18087-x.
To understand the association between sodium and potassium consumption levels, hypertension and knowledge, attitudes and behaviors (KAB) toward salt and the commitment to effective sodium reduction and potassium supplementation to achieve the purpose of suppressing hypertension. A stratified multistage random sampling method was used to obtain a representative provincial sample of 7512 residents aged 18-69 years through a cross-sectional survey by the Salt Reduction and Hypertension Prevention Project (SRHPP) in Zhejiang Province of China in 2017-2018. A screening including demographic, anthropometric, salt-related KAB and physical measurements was implemented, and 24-h urine of approximately 1/5 of the participants was collected and tested. The mean age was 44.8 years, 50.1% were women, 44.0% lived in urban areas, and hypertension or prehypertension accounted for approximately 35.0%. The mean 24-h urinary sodium and potassium excretion were 3848.5 (1661.1) mg/d and 1491.1 (710.9) mg/d, respectively. KAB in urban areas was generally more favorable than in rural areas, women were better than men, and the optimal blood pressure group was better than the other two groups (P < 0.05). However, the awareness and correct use rate of salt-restricted spoons, low-sodium salt and nutrition labeling were lower. A multivariable linear regression model indicated that KAB had a smaller effect on sodium (two indicators effective for promoting sodium reduction) and a greater effect on potassium (six indicators effective for promoting potassium supplementation) and mainly focused on knowledge and behavior indicators. A multivariable logistic regression model indicated that mastering more knowledge and taking active measures could effectively reduce the transition to hypertension, even if the individual was already in prehypertension. There is much room for improvement of salt-related KAB in the Chinese population. A clear association indicates that KAB can help to reduce sodium and supplement potassium, especially potassium, and help to suppress the development of hypertension. The role of beliefs in KAB should be fully valued and improved, similar to knowledge and behaviors. This study provides important evidence and insight into China's efforts to meet the targets of salt reduction and hypertension prevention.
为了了解钠和钾的摄入量、高血压以及盐的知识、态度和行为（KAB）与减少钠和补充钾以达到抑制高血压的目的之间的关联。本研究采用分层多阶段随机抽样方法，通过中国浙江省盐与高血压预防项目（SRHPP）于 2017-2018 年进行的横断面调查，获得了具有代表性的省级 18-69 岁居民样本 7512 例。实施了包括人口统计学、人体测量学、盐相关 KAB 和身体测量在内的筛查，并收集了约 1/5 参与者的 24 小时尿液进行检测。参与者的平均年龄为 44.8 岁，50.1%为女性，44.0%居住在城市地区，高血压或高血压前期约占 35.0%。平均 24 小时尿钠和钾排泄量分别为 3848.5（1661.1）mg/d 和 1491.1（710.9）mg/d。城市地区的 KAB 普遍优于农村地区，女性优于男性，最佳血压组优于其他两组（P<0.05）。然而，对限盐勺、低钠盐和营养标签的认识和正确使用率较低。多变量线性回归模型表明，KAB 对钠的影响较小（促进减少钠的两个指标有效），对钾的影响较大（促进补充钾的六个指标有效），主要集中在知识和行为指标上。多变量逻辑回归模型表明，掌握更多知识并采取积极措施可以有效降低向高血压的转变，即使个体已经处于高血压前期。中国人群的盐相关 KAB 还有很大的改进空间。明确的关联表明，KAB 可以帮助减少钠和补充钾，特别是钾，并有助于抑制高血压的发展。应充分重视和改善信念在 KAB 中的作用，类似于知识和行为。本研究为中国实现减盐和预防高血压的目标提供了重要的证据和见解。
