Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
PLoS One. 2024 Nov 22;19(11):e0311908. doi: 10.1371/journal.pone.0311908. eCollection 2024.
Excessive sodium intake is associated with high blood pressure and an increased risk of cardiovascular disease. However, reducing dietary salt has been challenging due to a lack of awareness and a high threshold in detecting saltiness.
The goal of this study is to evaluate the effectiveness of a combined intervention (intensive dietary education, food reformulation, environmental changes to facilitate salt reduction, and salt meter utilization), in comparison to standard education only, on salt intake and blood pressure.
A cluster randomized-controlled trial was conducted on 219 hypertensive adults aged 18 to 70 years in Uthaithani, Thailand. Participants were randomized 1:1 into the intervention group (n = 111) and the control group (n = 108).
There were no differences in baseline characteristics between groups. The mean systolic and diastolic blood pressure was 143.6 and 82.1 mmHg and 142.2 and 81.4 mmHg in the intervention group, and the control group, respectively. The median 24-hour urinary sodium excretion was 3565 and 3312 mg/day, in the intervention and the control group, respectively. After 12 weeks, the change in systolic blood pressure was -13.5 versus -9.5 mmHg (P = 0.030) and diastolic blood pressure was -6.4 versus -4.8 mmHg (P = 0.164) in the intervention and control groups, respectively. Moreover, a reduction in 24-hour urine sodium excretion was observed [-575 versus -299 mg/day in the intervention and control groups, respectively (P = 0.194)]. The change in 24-hour urine sodium excretion was statistically significant and reduced from baseline in the intervention group (P = 0.004). The dietary salt intake was significantly improved and was statistically different between groups (P = 0.035).
The combined intervention significantly decreased systolic blood pressure and showed a trend towards reduced urine sodium excretion in hypertensive patients. These comprehensive approaches may be beneficial in reducing blood pressure and salt intake in the community.
This trial was registered at Clinicaltrials.gov with the identifier NCT05397054. https://classic.clinicaltrials.gov/ct2/show/NCT05397054.
摄入过多的钠与高血压以及心血管疾病风险增加有关。然而，由于缺乏意识和对咸味的高阈值，减少饮食中的盐一直具有挑战性。
本研究旨在评估强化饮食教育、食品配方改良、促进减盐的环境变化以及盐表的使用等综合干预措施与单纯教育相比，对盐摄入量和血压的影响。
在泰国乌泰他尼的 219 名年龄在 18 至 70 岁的高血压成年人中进行了一项群组随机对照试验。参与者按照 1:1 的比例随机分为干预组（n=111）和对照组（n=108）。
两组基线特征无差异。干预组和对照组的收缩压和舒张压平均值分别为 143.6 和 82.1mmHg 和 142.2 和 81.4mmHg。干预组和对照组的 24 小时尿钠排泄中位数分别为 3565 和 3312mg/天。12 周后，收缩压的变化分别为-13.5mmHg 和-9.5mmHg（P=0.030），舒张压的变化分别为-6.4mmHg 和-4.8mmHg（P=0.164）。此外，观察到 24 小时尿钠排泄减少[-575 与 -299mg/天，分别在干预组和对照组（P=0.194）]。干预组的 24 小时尿钠排泄变化有统计学意义，且较基线下降（P=0.004）。膳食盐摄入量显著改善，组间差异有统计学意义（P=0.035）。
综合干预可显著降低高血压患者的收缩压，并显示出减少尿钠排泄的趋势。这些综合方法可能有益于减少社区中的血压和盐摄入量。
本试验在 Clinicaltrials.gov 注册，标识符为 NCT05397054。https://classic.clinicaltrials.gov/ct2/show/NCT05397054。
