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自我实施的饮食钠减少和原发性高血压患者的血压:一项随机临床试验。

Self-Performed Dietary Sodium Reduction and Blood Pressure in Patients With Essential Hypertension: A Randomized Clinical Trial.

机构信息

University Clinic in Nephrology and Hypertension, Department of Medicine Gødstrup Hospital Herning Denmark.

Department of Clinical Medicine Aarhus University Aarhus Denmark.

出版信息

J Am Heart Assoc. 2024 Jun 18;13(12):e034632. doi: 10.1161/JAHA.124.034632. Epub 2024 Jun 6.

DOI:10.1161/JAHA.124.034632
PMID:38842286
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11255768/
Abstract

BACKGROUND

Hypertension is the leading risk factor for cardiovascular disease worldwide. Patients with blood pressure (BP) response to dietary sodium reduction are referred to as "salt sensitive." Salt sensitivity (SS) might be due to differences in sodium storage capacity and the erythrocyte SS examines this capacity of the red blood cells. This study aimed to test the effect of a self-performed sodium reduced diet on BP in patients with essential hypertension and examine whether erythrocyte SS predicts SS.

METHODS AND RESULTS

Seventy-two patients with hypertension were included and randomized 2:1 to either sodium reduction or a control group for 4 weeks. Blood samples, 24-hour BP measurement, and 24-hour urine collection were performed before and after. The intervention group received advice on how to lower sodium intake. Urinary sodium excretion decreased 66 mmol (95% CI, -96 to -37 mmol) in the intervention group compared with the control group. Systolic 24-hour BP decreased 9 mm Hg after low-sodium diet compared with the control group (95% CI, -13 to -4 mm Hg). Similarly, the difference in reduction in diastolic BP between the groups was 5 mm Hg (95% CI, -8 to -1 mm Hg). We found no correlation between erythrocyte SS at baseline and decrease in 24-hour BP, neither systolic nor diastolic (=0.66 and  = 0.84).

CONCLUSIONS

Self-performed sodium reduction was feasible and led to decrease in 24-hour BP of 9/5 mm Hg compared with a control group. The erythrocyte SS did not correlate to the change in BP after lowering sodium intake.

REGISTRATION

URL: https://clinicaltrials.gov; Unique Identifier: NCT05165823.

摘要

背景

高血压是全球心血管疾病的主要危险因素。对膳食钠减少有血压反应的患者被称为“盐敏感”。盐敏感性(SS)可能是由于钠储存能力的差异,而红细胞 SS 则检查红细胞的这种能力。本研究旨在测试自行进行的低盐饮食对原发性高血压患者血压的影响,并检查红细胞 SS 是否可以预测 SS。

方法和结果

共纳入 72 例高血压患者,随机分为 2:1 进入钠减少组或对照组,干预时间为 4 周。分别在干预前后采集血样、24 小时血压测量和 24 小时尿液收集。干预组接受了关于如何减少钠摄入的建议。与对照组相比,干预组尿钠排泄减少 66mmol(95%CI,-96 至-37mmol)。与对照组相比,低盐饮食后 24 小时收缩压降低 9mmHg(95%CI,-13 至-4mmHg)。同样,两组间舒张压降低的差异为 5mmHg(95%CI,-8 至-1mmHg)。我们发现基线红细胞 SS 与 24 小时 BP 的降低之间没有相关性,无论是收缩压还是舒张压(r=0.66 和 r=0.84)。

结论

自行进行的钠减少是可行的,与对照组相比,可使 24 小时 BP 降低 9/5mmHg。红细胞 SS 与降低钠摄入后血压的变化无关。

注册

网址:https://clinicaltrials.gov;唯一标识符:NCT05165823。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f7e/11255768/bb5b14af968a/JAH3-13-e034632-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f7e/11255768/e2184437ea2f/JAH3-13-e034632-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f7e/11255768/bb5b14af968a/JAH3-13-e034632-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f7e/11255768/e2184437ea2f/JAH3-13-e034632-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f7e/11255768/bb5b14af968a/JAH3-13-e034632-g001.jpg

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2
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BMC Nephrol. 2023 Sep 19;24(1):274. doi: 10.1186/s12882-023-03333-9.
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