Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
J Clin Endocrinol Metab. 2024 Jan 18;109(2):e773-e779. doi: 10.1210/clinem/dgad512.
Black women have a higher prevalence of hypertension as compared to White women. Differences in dietary sodium intake have been implicated as a contributing factor for the disparities in hypertension.
Our objective was to understand whether young Black women would have higher systolic blood pressure (SBP) than White women even on controlled sodium diets and to determine whether SBP differences were due to differences in dietary sodium intake and/or aldosterone regulation.
The analyses included 525 hypertensive and normotensive women (ages 18-71) from the International Hypertensive Pathotype consortium, who were maintained on liberal sodium (LIB; >200 mEq sodium/day) and restricted sodium (RES; 10 mEq sodium/day) diets.
Multivariate regression analyses (adjusted for age, race, study site, body mass index) found that Black women (ages 18-50) had significantly higher SBP than White women on both sodium diets: +8.7 ± 2.7 mmHg (P-value = .002) on a LIB diet and +8.5 ± 2.5 mmHg (P-value = .001) on a RES diet. Even among 18- to 35-year-olds-who were normotensive and nonobese-Black women had higher SBP: +7.9 ± 2.4 mmHg (P-value = .001) on a LIB diet and +7.6 ± 2.7 mmHg (P-value = .005) on a RES diet. Younger Black women also had higher plasma aldosterone concentration to plasma renin activity ratio (ARR) on both LIB and RES diets as well as a higher sodium-modulated aldosterone suppression-stimulation index-an indicator of aldosterone dysregulation. In younger Black women-but not in White women-there was a significant association between SBP and ARR on both LIB and RES diets.
Young Black women had increased SBP and ARR as compared to White women on LIB and RES diets, which offers insights into the possible mechanisms for the increased hypertension and cardiovascular disease risk in an at-risk and understudied population.
与白人女性相比，黑人女性高血压的患病率更高。饮食中钠摄入量的差异已被认为是导致高血压差异的一个因素。
我们的目的是了解即使在控制钠饮食的情况下，年轻黑人女性的收缩压（SBP）是否会高于白人女性，并确定 SBP 差异是否是由于饮食钠摄入量和/或醛固酮调节的差异。
分析包括来自国际高血压表型联盟的 525 名高血压和血压正常的女性（年龄 18-71 岁），她们分别接受宽松钠（LIB；>200 mEq 钠/天）和限制钠（RES；10 mEq 钠/天）饮食。
多元回归分析（调整年龄、种族、研究地点、体重指数）发现，黑人女性（年龄 18-50 岁）在两种钠饮食中 SBP 均明显高于白人女性：LIB 饮食时为+8.7±2.7mmHg（P 值=0.002），RES 饮食时为+8.5±2.5mmHg（P 值=0.001）。即使在 18-35 岁的非肥胖、血压正常的年轻女性中，黑人女性的 SBP 也更高：LIB 饮食时为+7.9±2.4mmHg（P 值=0.001），RES 饮食时为+7.6±2.7mmHg（P 值=0.005）。年轻黑人女性在两种 LIB 和 RES 饮食中血浆醛固酮浓度与血浆肾素活性比值（ARR）更高，并且具有更高的钠调节醛固酮抑制-刺激指数-一种醛固酮失调的指标。在年轻黑人女性中，但不是在白人女性中，在两种 LIB 和 RES 饮食中 SBP 与 ARR 之间存在显著相关性。
与 LIB 和 RES 饮食的白人女性相比，年轻黑人女性的 SBP 和 ARR 更高，这为了解高危和研究不足人群中高血压和心血管疾病风险增加的可能机制提供了线索。
