36至37岁人群样本中左心室质量的相关因素。关注生活方式和盐摄入量。

Correlates of left ventricular mass in a population sample aged 36 to 37 years. Focus on lifestyle and salt intake.

作者信息

Kupari M, Koskinen P, Virolainen J

机构信息

Division of Cardiology (First Department of Medicine), Helsinki University Central Hospital, Finland.

出版信息

Circulation. 1994 Mar;89(3):1041-50. doi: 10.1161/01.cir.89.3.1041.

DOI:10.1161/01.cir.89.3.1041

PMID:8124789

Abstract

BACKGROUND

Echocardiographically determined left ventricular (LV) mass predicts adverse cardiovascular events in the general population. We have assessed the correlates of LV mass in a population-based study focusing on lifestyle and salt intake.

METHODS AND RESULTS

A random sample of 120 persons born in 1954 was invited; 93 (42 men) entered the study. The subjects' physical activity and alcohol, tobacco, and coffee consumption were quantified by 2-month dairy follow-up, and sodium intake was quantified by 7-day food records. Blood pressure was averaged for casual cuff measurements made 2 months apart. LV mass was determined by M-mode echocardiography, and stroke volume was determined by Doppler. Hematocrit and serum insulin were measured. In multiple linear regression analysis, LV mass was related positively and independently (P < .05) to body weight, systolic blood pressure, stroke volume, sodium intake, hematocrit, and energy expenditure in leisure-time physical activity. Additional analyses showed that the relation of LV mass to daily sodium intake depended on blood pressure (P < .001 for the interaction); the multiple regression coefficient (+/- SE) was 0.41 +/- 0.11 g.mEq-1 x d-1 (P = .001) in subjects with systolic blood pressure above the population median but statistically nonsignificant (-0.15 +/- 0.10 g.mEq-1 x d-1) in those with lower blood pressure. LV mass was clearly elevated only in persons with both blood pressure and sodium intake above the population medians.

CONCLUSIONS

Body weight, blood pressure, stroke volume, sodium intake, physical activity, and hematocrit are independent predictors of LV mass among unselected persons aged 36 to 37 years. The synergistic interaction of dietary salt with blood pressure suggests that high sodium intake may sensitize the heart to the hypertrophic stimulus of pressure load. Prospective studies are needed to confirm these cross-sectional associations.

摘要

背景

超声心动图测定的左心室（LV）质量可预测普通人群的不良心血管事件。我们在一项基于人群的研究中，重点关注生活方式和盐摄入量，评估了LV质量的相关因素。

方法与结果

邀请了1954年出生的120人的随机样本；93人（42名男性）进入研究。通过为期2个月的饮食随访对受试者的身体活动以及酒精、烟草和咖啡的摄入量进行量化，通过7天的饮食记录对钠摄入量进行量化。相隔2个月进行的偶测袖带血压测量取平均值。通过M型超声心动图测定LV质量，通过多普勒测定每搏输出量。测量血细胞比容和血清胰岛素。在多元线性回归分析中，LV质量与体重、收缩压、每搏输出量、钠摄入量、血细胞比容以及休闲时间体力活动中的能量消耗呈正相关且独立相关（P < .05）。进一步分析表明，LV质量与每日钠摄入量的关系取决于血压（交互作用P < .001）；收缩压高于人群中位数的受试者中，多元回归系数（±标准误）为0.41 ± 0.11 g·mEq⁻¹·d⁻¹（P = .001），而血压较低的受试者中该系数无统计学意义（-0.15 ± 0.10 g·mEq⁻¹·d⁻¹）。仅在血压和钠摄入量均高于人群中位数的人群中，LV质量明显升高。