Yamanaka Noriko, Itabashi Mitsuyo, Fujiwara Yoshinori, Nofuji Yu, Abe Takumi, Kitamura Akihiko, Shinkai Shoji, Takebayashi Toru, Takei Takashi
Departments of Nephrology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
Hypertens Res. 2023 Mar;46(3):556-564. doi: 10.1038/s41440-022-01135-4. Epub 2022 Dec 16.
The association between the urinary sodium (Na)/potassium (K) ratio and hypertension is well recognized. We investigated whether the urinary Na/K ratio might be associated with hypertension in community-dwelling older adults and whether the association was influenced by habitual dietary patterns. We enrolled a total of 684 older adults (mean age, 76.8 years) and conducted health examinations at Kusatsu, Japan, in 2021. The urinary Na/K ratio was found to be independently associated with systolic blood pressure (SBP) (p < 0.0001), years of education (p = 0.0027), number of cohabitants (p = 0.0175), estimated glomerular filtrate rate (eGFR) (p = 0.0244), and Geriatric Depression Scale short-version (GDS15) score (p = 0.0366). In addition, an unsupervised hierarchical clustering analysis revealed a spectrum of habitual dietary patterns for higher and lower values of the urinary Na/K ratio. The decision tree indicated that the urinary Na/K ratio was associated with the history of milk consumption. A positive history of daily milk consumption predicted a mean urinary Na/K ratio of 2.8, and a negative history of daily milk consumption predicted a mean urinary Na/K ratio of 3.3. Furthermore, the frequency of fruit and vegetable consumption also predicted the urinary Na/K ratio. The relationship between the urinary Na/K ratio and hypertension was influenced by the frequency of consumption of milk, fruits, and vegetables in the subjects. This finding might be due to the influence of education and/or depression. The results suggested the importance of nutritional education in the development of hypertension.
尿钠（Na）/钾（K）比值与高血压之间的关联已得到充分认识。我们调查了尿Na/K比值是否可能与社区居住的老年人高血压相关，以及这种关联是否受习惯性饮食模式的影响。2021年，我们在日本草津共招募了684名老年人（平均年龄76.8岁）并进行了健康检查。发现尿Na/K比值与收缩压（SBP）（p < 0.0001）、受教育年限（p = 0.0027）、同居人数（p = 0.0175）、估计肾小球滤过率（eGFR）（p = 0.0244）和老年抑郁量表简版（GDS15）评分（p = 0.0366）独立相关。此外，无监督层次聚类分析揭示了尿Na/K比值高低不同时的一系列习惯性饮食模式。决策树表明尿Na/K比值与牛奶消费史有关。每日牛奶消费的阳性史预测尿Na/K比值平均为2.8，每日牛奶消费的阴性史预测尿Na/K比值平均为3.3。此外，水果和蔬菜消费频率也可预测尿Na/K比值。受试者中牛奶、水果和蔬菜的消费频率影响了尿Na/K比值与高血压之间的关系。这一发现可能归因于教育和/或抑郁的影响。结果表明营养教育在高血压发病中的重要性。
