农村非高血压人群空腹血糖与血压因果关系分析

目的了解农村非高血压人群空腹血糖(FPG)与血压的因果关系,为高血压及糖尿病危险因素的早期防控提供参考依据。方法于2013年1—8月在辽宁省大洼、彰武和辽阳县农村地区采用多阶段随机整群抽样方法建立了心血管疾病研究队列,并于2015年8月—2016年1月对其中4 145名≥35岁农村居民进行随访调查;采用双向因果关联模型描述FPG与血压的因果关系,并应用多元线性回归模型进一步验证。结果 4 145名农村非高血压人群的平均随访时间为(28.79±3.49)个月,基线和随访时的FPG分别为(5.51±0.83)和(5.48±1.07)mmol/L,收缩压(SBP)分别为(124.05±9.62)和(125.12±14.63) mm Hg,舒张压(DBP)分别为(75.17±7.24)和(75.88±9.33)mm Hg;在在双向因果关系模型中,基线FPG先于随访SBP(ρ2=0.063,P 0.001)和随访DBP(ρ2=0.029,P=0.031);多元线性回归模型进一步验证了双向因果关联模型中的结果,基线FPG影响随访SBP(β=1.535,P 0.001)和随访DBP(β=0.393,P=0.015);SBP和DBP的变化值均值在FPG变化值的Q1、Q2、Q3、Q4分别为–0.79和–0.25 mm Hg、0.74和0.49 mm Hg、1.17和0.91 mm Hg、3.11和1.68 mm Hg;FPG变化值的四分位数越高,SBP和DBP的变化值均值越大(均P 0.001)。结论农村非高血压人群FPG和血压的因果关系是单向的,即FPG升高先于血压升高。     

安徽省心血管病患病风险人群社区公共卫生综合干预对血压水平控制效果分析

  目的  分析不同心血管疾病(cardiovascular disease, CVD)患病风险人群社区公共卫生综合干预血压控制效果。  方法  收集2016—2020年安徽省社区公共卫生综合干预资料(包括基线、3个月、12个月随访数据),采用《中国心血管疾病风险评估和管理指南》推荐的10年CVD风险评估模型将研究对象分为心血管疾病高危和非高危人群,比较高危和非高危人群社区公共卫生综合干预血压控制效果。  结果  共随访3 755名研究对象,CVD高危人群645人,标化检出率10.9%。随访12个月与基线相比,高危人群SBP和DBP分别下降了16.47 mm Hg(95% CI:-18.09~-14.86)、2.66 mm Hg(95% CI:-3.63~-1.69),非高危人群SBP和DBP分别下降了10.43 mm Hg(95% CI:-11.16~-9.70)、2.41 mm Hg(95% CI:-2.81~-2.01);3个月与基线相比,高危人群SBP和DBP分别下降了12.27 mm Hg(95% CI:-13.88~-10.65)、3.66 mm Hg(95% CI:-4.54~-2.77),非高危人群SBP和DBP分别下降了6.05 mm Hg(95% CI:-6.80~-5.30)、2.61 mm Hg(95% CI:-3.00~-2.23)。高危人群随访3个月后SBP下降水平、随访12个月后SBP和DBP下降水平明显高于非高危组(t=-5.100,t=-5.873,t=-2.729,均有P＜0.05)。  结论  社区公共卫生综合干预对CVD高危人群血压改善优于非高危人群。因此,未来的公共卫生工作应进一步关注非高危人群。     

噪声作业工人听力损失对血压水平及高血压患病影响探讨

目的噪声作为一种常见的职业性危害因素广泛存在于各工厂企业中,其对劳动者健康的影响是多方面的,长期暴露于噪声环境不仅可造成特异性的听觉损伤,还可对心血管系统、神经系统、内分泌系统及消化系统等产生非特异性影响。本研究探讨噪声作业工人听力损失对血压水平及高血压患病的影响。方法收集深圳市龙华区2017-01-01-2017-12-31某企业1 008名噪声作业工人在岗期间的职业健康检查资料,以听力损失作为累积噪声暴露量的替代指标,经年龄和接噪工龄分层后,分析不同听力损失组和听力正常组的血压值及高血压患病率差异。结果年龄≤40岁的调查对象,听力正常组、高频听损组、语频及高频听损组的收缩压(systolic blood pressure,SBP)分别为(124.0±13.5)、(130.9±11.0)和(132.4±10.5)mm Hg,差异有统计学意义,F=14.411,P0.001;舒张压(diastolic blood pressure,DBP)分别为(75.6±8.7)、(79.2±7.8)和(81.3±6.0)mm Hg,差异有统计学意义,F=11.941,P0.001;高血压患病率分别为13.1%、26.7%和30.3%,差异有统计学意义,χ2=13.860,P=0.001。听力损失者的SBP、DBP和高血压患病率均高于听力正常者。工龄5年的听力损失者SBP(F=9.068,P0.001)、DBP(F=5.676,P=0.004)和高血压患病率(χ2=8.834,P=0.012),以及工龄5～10年的听力损失者SBP(F=6.445,P=0.002)、DBP(F=8.015,P0.001)和高血压患病率(χ2=9.757,P=0.008),均高于听力正常者。随着听力由正常到高频受损再到累及语频受损,SBP、DBP和高血压患病率均有升高趋势。结论年龄≤40岁、接噪工龄≤10年的噪声作业工人听力损失与血压及高血压有关,需重点关注职业性噪声对年轻工人血压及高血压的影响。     

低钠富钾替代盐对农村社区人群血压影响的现场观察

目的 评价市售低钠富钾替代盐对农村社区居民血压的影响效果。方法采用流行病学类实验设计,在山东省莱芜市2个农村社区,经过血压筛查,将411名30～ 60岁的研究对象分为高血压组和非高血压组,两组均以家庭为单位给予3个月的低钠富钾替代盐替换普通食盐进行干预,定期观察血压及其24 h尿钠的变化。结果用低钠富钾替代盐干预1个月时高血压组和非高血压组人群血压开始呈下降趋势,3个月后评估时高血压组收缩压(SBP)平均下降7.4 mm Hg(1 mm Hg=0.133 kPa;t= 10.096,P=0.000),舒张压(DBP)下降3.8 mm Hg(t=8.017,P=0.000);非高血压组SBP平均下降1.2 mm Hg(t=2.507,P= 0.007),DBP下降1.0 mm Hg(t=2.987,P=0.002)。干预3个月后评估时高血压组24 h尿钠平均下降15.5 mmol(t= 1.803,P=0.037),尿钾上升4.2 mmol(t’=2.132,P=0.018),钠钾比下降1.2(t=2.786,P=0.003);非高血压组24 h尿钠平均下降1.7 mmol(t =0.211,P=0.417),尿钾上升3.7 mmol(t’=2.207,P=0.015),钠钾比值下降0.7(t= 1.818,P=0.036)。结论低钠富钾替代盐能有效降低人群血压水平,且人群依从性较好,是一种有效的非药物预防控制高血压方法。     

浙江省成年居民血压水平区域聚集性和危险因素的多水平模型分析

目的应用多水平模型分析浙江省成年居民血压水平的区域聚集性和危险因素。方法采用多阶段整群随机方法抽取浙江省60个街道／乡镇共17 437名成年人作为研究对象,使用2水平模型分别分析SBP和DBP。结果男性SBP为(125,14±17.90)mmHg、DBP(80.02±10.07)mmHg,女性SBP为(123.36±20.20)mmHg DBP(77.42 4-10.09)mmHg;城市人群SBP为(126.294-19.46)mmHg、DBP(79.64±10.20)mmHg,农村人群SBP为(122.82±18.86)mmHg、DBP(7799±10.08)mmHg,差异均有统计学意义(P<0.001);SBP和DBP与年龄的Pearson相关系数分别为0.44和0.21(P<0.001);在SBP和DBP的变异中,环境因素分别占5.24%和4.96%;个体水平的年龄、性别、高血压家族史、服用降压药、体育锻炼、吸烟、饮酒、BMl、WC、FPG、TG和TC对SBP和DBP均有影响(P<0.05),家庭经济收入对SBP有影响(Jp<0.05),文化程度、限盐摄人、职业强度只寸DBP有影响(P<0.05);FPG和TC水平与SBP之间的数量关系以及TC水平与DB之间的数量关系在街道／乡镇间存在变化(P<0.05)。结论浙江省成年居民血压分布具有地区聚集件,高血压的预防既需要考虑年龄、BMI、FPG、TG和TC等个体因素,还应考虑地区因素以及不同地区人群对危险因素的敏感性,从而制定针对不同区域的预防策略。     

中老年人5 min内多次测血压结果的对比分析

[目的]探讨中老年人短时间内血压变化的情况及临床意义。[方法]对2002年1月～2005年12月1 179例门诊测量血压的中老年人,采用调查形式在5 min内测量血压3次,作有关分析。[结果]中年组BP 80～200/54～110 mmHg,平均142.6/81.5 mmHg;老年组BP 88～230/50～120 mmHg,平均145.1/76.4 mmHg;第3次比第1次所测血压,SBP下降人数占65.0%,升高占22.8%,总的变化率为87.8%,DBP下降占51.7%,升高占16.8%,总的变化率为68.5%,SBP、DBP波动值最高为40 mmHg,5 min内SBP及DBP变化以下降为主;中老年组SBP及老年组DBP平均压差均大于5 mmHg。中年、老年平均压差及SBP升高下降及DBP下降变化率对比差异无统计学意义(t=1.831及以下,P﹥0.05);DBP升高变化率对比差异有统计学意义(t=2.133,P﹤0.05)。SBP变化压差﹥5 mmHg占70.2%,DBP变化压差﹥5 mmHg占41.1%。压差﹥5 mmHg的人群,SBP、DBP升降率在中年、老年组及高血压与非高血压各组相比,经t检验均无统计学意义。[结论]要关注SBP、DBP压差升高﹥5 mmHg的人群。中老年人短时间内自身调节血压的功能存在着一定变化空间,这变化空间在给予药物康复时是应考虑的因素。短时内多次测量血压,拉近医患距离,减轻就医者心理压力。     

某乡镇居民原发性高血压患者唾液酸等血液化学指标水平调查及危险因素分析

目的探讨唾液酸(sialic acids,SA)等血液生化指标对高血压病的影响和危险因素分析。方法四川省南充市嘉陵区曲水镇2014年2月居民慢性病普查人群477人,测量血压、身高、体质量,询问病史,并作血液SA、血糖(Glu)、高敏C反应蛋白(hs-CRP)、血脂水平等检测,按照血压水平分为血压正常组131例、正常高值血压组83例、高血压组263例,采用多元线性回归分析、单因素分析等统计学方法分析血浆SA等指标对血压的影响。结果 3组人群血浆唾液酸增高检出率,正常血压组19.81%、正常高值血压组49.4%、高血压组52.7%;血浆唾液酸水平(mg/dl)正常血压组(62.7±5.9)与正常高值血压组(68.2±7.7)比较,差异有统计学意义(P0.05),与高血压组(70.0±8.8)比较差异有统计学意义(P0.01)。单因素分析发现,影响收缩压(SBP)的血液检测指标有SA(F=7.46,P=0.001)、Glu(F=3.407,P=0.034)、总胆固醇(TC)(F=4.886,P=0.048)和低密度脂蛋白胆固醇(LDL)(F=4.492,P=0.012);而影响舒张压(DBP)的检测指标主要有SA(F=5.175,P=0.006)。多元线性回归分析结果显示,SA和尿酸(UA)是SBP的影响因素(B=0.609,P=0.001,B=0.043,P=0.016),SA是DBP的影响因素(B=0.313,P=0.003)。结论血浆SA与血压独立相关,是影响原发性高血压的血液指标。     

高血压患者时程投药与吲哒帕胺对血浆C型利钠肽的影响

目的　观察时程投药治疗高血压的疗效 ;探讨高血压患者血浆C型利钠肽 (C -typenatriureticpeptide,CNP)的浓度与血压的关系及吲哒帕胺对其的影响。方法　高血压组采用单盲法分为常规组及时程组 ,另设正常组做对照。结果　时程投药降压血压波动幅度小。高血压患者血浆CNP明显低于正常组 (P <0 .0 0 1 )。时程组治疗后血CNP升高多于常规组。血浆CNP浓度与血压的高低呈负相关 (疗前SBP ,r =- 0 .81 6 ,P <0 .0 5 ,DBP ,r=- 0 .968,P<0 .0 1。疗后SBP ,r=- 0 .865 ,P <0 .0 5 ,DBP ,r=- 0 .931 ,P <0 .0 1 )。结论　时程给药血压谷峰差值小 ,血压较稳定。CNP参与血压的稳定性调节。吲哒帕胺有血管肽酶抑制剂的活性     

天津市和平区新兴街社区老年人肾功能变化影响因素调查分析

目的随着我国人口老龄化,慢性肾脏病成为研究热点。本研究探讨社区老年人群肾脏功能随增龄变化特点及其影响因素。方法回顾2012年及2016年天津市新兴街社区老年人健康体检数据,筛选出具有完整查体数据的老年人2 110名,以2012年估算肾小球滤过率(estimated glomerular filtration rate,eGFR)为基线值,分析基线水平eGFR增龄变化;计算2016年和2012年eGFR值下降速率(ΔeGFR),分析5年间eGFR增龄变化。使用线性回归分析年龄、性别、高血压病、糖尿病和血脂紊乱对eGFR增龄变化影响。结果横断面研究发现,老年人eGFR平均每年下降0.8～0.9mL/(min·1.73m~2);纵向研究发现,老年人eGFR平均每年下降(2.96±0.36)mL/(min·1.73m~2),ΔeGFR平均每年下降速率约为3%。不同性别(t=8.896,P=0.003)、年龄(F=72.793,P0.001)和疾病(F=6.282,P0.001)eGFR水平差异有统计学意义;不同性别(t=4.898,P=0.027)、年龄(F=42.823,P0.001)和疾病(F=4.351,P0.005)ΔeGFR水平差异有统计学意义。线性回归分析发现,影响eGFR变化的危险因素为年龄(t=-12.098,P0.001)、空腹血糖(t=4.087,P0.001)、高血压病(t=-3.475,P=0.001)、三酰甘油(t=-2.979,P=0.003)和性别(t=2.643,P=0.008)。影响5年后ΔeGFR危险因素为年龄(t=-9.104,P0.001)、高血压病(t=-3.229,P=0.001)、空腹血糖(t=3.358,P=0.001)和三酰甘油(t=-2.545,P=0.011)。结论年龄、空腹血糖、高血压和三酰甘油是影响eGFR基线水平与5年后ΔeGFR危险因素。     

邯郸地区煤矿工人血红蛋白水平与血压水平的相关性研究

目的探讨煤矿工人Hb含量与血压水平的相关性。方法以邯郸地区某煤矿2 375名煤矿工人为研究对象。测量收缩压(SDP)和舒张压(DBP)。根据其血压水平分为3组:正常血压组(SBP120mm Hg、DBP80mm Hg)957例,高血压前期(SBP:120~139mm Hg、DBP:80~89 mm Hg)961例,高血压组(SBP≥140mm Hg、DBP≥90 mm Hg)457例;根据Hb四分位法将研究对象分为4组,即A组:Hb142g/L;B组:142g/L≤Hb148g/L;C组:148g/L≤Hb155g/L;D组:Hb≥155g/L,对数据进行统计分析。结果随着血压的逐渐升高,Hb含量有明显上升趋势,正常血压组(146.53±9.75)g/L、高血压前期(148.99±9.69)g/L,高血压组(150.05±9.79)g/L组间比较,差异有统计学意义(P0.05)。Hb含量四分位C及D组的SBP、DBP水平高于A、B组,且差异有统计学意义(P0.05)。Pearson相关分析显示,Hb含量与SBP、DBP等均呈显著正相关。结论该人群随着血压的水平升高外周Hb水平呈逐渐上升的趋势,Hb水平的升高可能增加高血压或高血压前期的发病率。     

The independent effect of habitual cigarette and coffee consumption on blood pressure

The authors investigated the possible relation between habitual cigarette and coffee consumption and blood pressure (BP) levels in 7506 men and 2095 women. The study population were managers and employees examined in northern Italy between 1986–1988. In particular, the hypothesis of a substantial independence between smoking-BP and coffee-BP was tested. BP levels were corrected for age, body mass index, physical activity, and alcohol consumption by analysis of covariance. Significantly, smoking was inversely related to BP, both in men (SBP, P < 0.001, DBP, P < 0.001) and women (SBP, P = 0.001, DBP, P = 0.012). In particular, the BP of non-smoking men, SBP/DBP, was 131.0/83.5, whereas in male smokers up to and over 20 cigarette/day, BP was 128.1/82.0 and 128.1/82.1 respectively. Coffee consumption was related to BP levels in men (SBP, P < 0.001; DBP, P = 0.009), but not in women (SBP, P = 0.320; DBP, P = 0.982). BP in male subjects was 131.3/83.5 in non-drinkers, 130.7/83.3 in those drinking 1–3 cups/day, 128.4/82.6 and 127.2/81.8 in drinkers of 4–5 and over 5 cups/day, respectively. No significant interactions were demonstrated, thus the relationship between habitual smoking and coffee consumption with BP appears to agree with an additive model.Corresponding author.     

Interrelations among smoking habits, casual blood pressure and intraocular pressure in middle and old-aged Japanese residents

Objectives To investigate the association of smoking habits with blood pressure (BP) and intraocular pressure (IOP), and to examine whether the smoking-BP association is related to the IOP level. Methods This study was conducted on the basis of a cross-sectional design using annual health check-up data during one-year between August, 1999 and August, 2000 for 611 middle and old-aged Japanese residents living in Ibaraki prefecture, Japan. Results After adjustment for age, gender, body mass index and alcohol intake score, the proportion of hypertensives, and the mean systolic and diastolic blood pressure (SBP and DBP) of the subjects without antihypertensive medications were the highest (50.4%, 129.6 mmHg and 75.9 mmHg, respectively) in the “smokers of 25 or more cigarettes per day with intraocular pressure (IOP)≥15 mmHg” of six subgroups crossed by three smoking categories (non-smokers, 1 to 24 cigarettes per day, and 25 or more cigarettes per day) and two IOP categories (less than 15 mmHg, and 15mmHg or greater). On the other hand, the adjusted proportion of hypertensives, and the adjusted mean SBP and DBP decreased with increasing smoking category in the individuals with less than 15 mmHg of the IOP (p for trend=0.028 for proportion of hypertensives 0.008 for the SBP, and 0.001 for the DBP, respectively). Conclusions Heavy smoking may be specifically related to ‘high BP accompanied by high IOP’, although the BP may be inversely associated with smoking under the condition without high IOP.     

Influence of albuminuria and glomerular filtration rate on blood pressure response to antihypertensive drug therapy

Background

Albuminuria and glomerular filtration rate (GFR), two factors linked to kidney and vascular function, may influence longitudinal blood pressure (BP) responses to complex antihypertensive drug regimens.

Methods

We reviewed the clinic records of 459 patients with hypertension in an urban, academic practice.

Results

Mean patient age was 57-years, 89% of patients were African American, and 69% were women. Mean patient systolic/diastolic BP (SBP/DBP) at baseline was 171/98 mmHg while taking an average of 3.3 antihypertensive medications. At baseline, 27% of patients had estimated (e)GFR <60 ml/min/1.73², 28% had micro-albuminuria (30–300 mg/g) and 16% had macro-albuminuria (>300 mg/g). The average longitudinal BP decline over the observation period (mean 7.2 visits) was 25/12 mmHg. In adjusted regression models, macro-albuminuria predicted a 10.3 mmHg lesser longitudinal SBP reduction (p < 0.001) and a 7.9 mmHg lesser longitudinal DBP reduction (p < 0.001); similarly eGFR <60 ml/min/1.73² predicted an 8.4 mmHg lesser longitudinal SBP reduction (p < 0.001) and a 4.5 lesser longitudinal DBP reduction (p < 0.001). Presence of either micro- or macro-albuminuria, or lower eGFR, also significantly delayed the time to attainment of goal BP.

Conclusions

These data suggest that an attenuated decline in BP in drug-treated hypertensives, resulting in higher average BP levels over the long-term, may mediate a portion of the increased risk of cardiovascular-renal disease linked to elevated urinary albumin excretion and reduced eGFR.     

高血压病患者血压昼夜节律异常与心率变异减低的关系

目的：探讨高血压２血压昼夜节律异常与心率变异（ＨＲＶ）减低之间的关系。方法：按ＷＨ标准选择高血压病患者７０例,同期分别作动态血压监测及动态心电图ＨＲＶ分析。结果：血压昼夜节律消失组（Ａ组）较血压昼夜节律正常级（Ｂ组）夜间收缩压（ＳＢＰ）、夜间舒张压（ＤＢＰ）、２４ｈ平均ＳＢＰ、２４ｈ平均ＤＢＰ分别增高１５ｍｍｇ（Ｐ〈０．０１）、６ｍｍＨｇ（Ｐ〈０．０１）、８ｍｍＨｇ（Ｐ〈０．０１）、６ｍｍＨｇ（Ｐ     

Relationship between dietary caffeine intake and blood pressure in adults

The aim of this study was to determine the consumption frequency of caffeinated foods and beverages and daily caffeine consumption amounts, and examine relation between caffeine and blood pressure (BP). A cross sectional door-to-door interview was conducted with 1329 volunteers between the ages of 20 and 60 (mean ages 29.9?±?10.8 years) and based in Ankara/Turkey. The rate of individuals whose BPs were above 140/90?mmHg was 13.5%. The median caffeine consumption was 150.0?±?122.06?mg. Although no significant correlation was found between total caffeine intake and diastolic blood pressure (DBP) of individuals, a positive correlation was observed between daily total caffeine and systolic blood pressure (SBP) (p?<?.05). Also, when analyzed factors that could be associated with DBP and SBP, BMI had effect in the model formed for both types of BP (p?(p?=?.002), gender and waist circumference related to DBP (p?<?.05) As a result relationship between caffeine intake and BP was affected other factors.     

Effect of candesartan cilexetil on diabetic and non-diabetic hypertensive patients: meta-analysis of five randomized double-blind clinical trials

Objective

To study the effect of candesartan cilexetil (CC) in the management of blood pressure (BP) in diabetic and non-diabetic hypertensive patients.

Methods

A selection of five randomized double-blind clinical trials in which patients were treated for hypertension with CC was analyzed. All of these were similar in design: i) a 4-week placebo run-in period, ii) a 4-to 6-week period (V1) with CC 8 mg once daily (od), after which the dosage was doubled if BP was not normalized (BP >140/90 or BP >130/80 mmHg in diabetes), and iii) a 4- to 6-week period (V2) with CC 8 or 16 mg od. Efficacy was measured at V1 and V2.

Results

702 patients were screened. The population consisted of 397 males (56.6%) with a mean age of 60 ± 11 years, with 153 diabetic (21.8%) and 549 non-diabetic (78.2%) patients. At baseline, mean BP values were 160/94/65 mmHg for SPB, DBP, and pulse pressure (PP) respectively, with differences between diabetic and non-diabetic patients. SBP, DBP, and PP values showed a significant reduction at V1 (p < 0.001) and V2 (p < 0.001) compared with baseline for all hypertensive patients. Mean changes at V2 in SBP and PP values were higher in diabetic than non-diabetic patients (p < 0.001), and to a lesser degree on DBP values (p = 0.034).

Conclusions

CC was effective in lowering BP in diabetic and non-diabetic hypertensive patients. CC is a promising therapy to manage hypertensive diabetic patients, as demonstrated by the significant BP reduction.

Short abstract

The effect of candesartan cilexetil (CC) on controlling blood pressure (BP) in hypertensive diabetic and non-diabetic patients was analyzed. Five randomized double-blind trials were pooled treating hypertension by CC (n = 702), including 153 diabetic (21.8%) and 549 non-diabetic (78.2%) patients. After treatment with CC (8–16 mg), significant reductions in SBP, DBP, and pulse pressure (PP) values were observed after 4–6 weeks (p < 0.001) and after 8–12 weeks (p < 0.001) compared with baseline for all hypertensive patients. Mean BP reductions after 8–12 weeks were higher in diabetic patients than non-diabetic (p < 0.001). CC is a promising therapy to treat hypertensive patients, both diabetic and non-diabetic.     

The Significance of Duration and Amount of Sodium Reduction Intervention in Normotensive and Hypertensive Individuals: A Meta-Analysis

The purpose of this meta-analysis was to establish the time for achievement of maximal blood pressure (BP) efficacy of a sodium reduction (SR) intervention and the relation between the amount of SR and the BP response in individuals with hypertension and normal BP. Relevant studies were retrieved from a pool of 167 randomized controlled trials (RCTs) published in the period 1973–2010 and integrated in meta-analyses. Fifteen relevant RCTs were included in the maximal efficacy analysis. After initiation of sodium reduction (range: 55–118 mmol/d), there were no significant differences in systolic blood pressure (SBP) or diastolic blood pressure (DBP) between measurements at weeks 1 and 2 (∆SBP: −0.18 mmHg/∆DBP: 0.12 mmHg), weeks 1 and 4 (∆SBP: −0.50 mmHg/∆DBP: 0.35 mmHg), weeks 2 and 4 (∆SBP: −0.20 mmHg/∆DBP: −0.10 mmHg), weeks 2 and 6 (∆SBP: −0.50 mmHg/∆DBP: −0.42 mmHg), and weeks 4 and 6 (∆SBP: 0.39 mmHg/∆DBP: −0.22 mmHg). Eight relevant RCTs were included in the dose-response analysis, which showed that within the established usual range of sodium intake [<248 mmol/d (5700 mg/d)], there was no relation between the amount of SR (range: 136–188 mmol) and BP outcome in normotensive populations [∆SBP: 0.99 mm Hg (95% CI: 2.12, 4.10), P = 0.53; ∆DBP: −0.49 mm Hg (95% CI: −4.0, 3.03), P = 0.79]. In contrast, prehypertensive and hypertensive populations showed a significant dose-response relation (range of sodium reduction: 77–140 mmol/d) [∆SBP: 6.87 mmHg (95% CI: 5.61, 8.12, P < 0.00001); ∆DBP: 3.61 mmHg (95% CI: 2.83, 4.39, P < 0.00001)]. Consequently, the importance of kinetic and dynamic properties of sodium reduction, as well as baseline BP, should probably be considered when establishing a policy of sodium reduction.     

体质指数、腰围、腰臀比、腰围身高比与城乡居民血压关系的研究

目的探讨反映肥胖的体格测量指标与血压的关系,并通过肥胖指标预测血压值。方法利用2006年"中国居民健康与营养调查"的数据,对我国九省城乡18～60岁的成年居民6 433人的体质指数(BMI)、腰围、腰臀比、腰围身高比,以及超重率、肥胖率、中心肥胖率、高血压患病率进行横断面分析,同时分析体质指数、腰围、腰臀比、腰围身高比与血压的关系,并通过多元回归方程以肥胖指标预测血压值。结果城市男性居民的平均BMI值、腰围、腰臀比、腰围身高比、收缩压、舒张压均显著高于农村居民(P<0.05)。城市女性居民的平均BMI值、腰围、超重率、肥胖率、中心肥胖率和高血压患病率均低于农村居民,但两者比较差异无显著性(P>0.05)。无论是收缩压还是舒张压,均随着BMI值、腰围、腰臀比和腰围身高比的增加而升高。多元线性回归的结果显示,女性的年龄回归系数要高于男性。男性BMI值每增加0.77、腰围每增加2.43cm、腰臀比每增加2.66%和腰围身高比每增加1.54%,其收缩压升高1mmHg;而女性,相应的值分别为0.75、2.12cm、2.54%和1.53%时,其收缩压升高1mmHg。多元逐步回归方程中,腰围身高比仅和女性舒张压有相关关系。结论肥胖指标与血压之间具有稳定的正向线性关系。腰围身高比对收缩压和舒张压的预测作用并不好于其他反映肥胖的指标。     

Indoor air pollution and blood pressure in adult women living in rural China

Background: Almost half of the world’s population uses coal and biomass fuels for domestic energy. Limited evidence suggests that exposure to air pollutants from indoor biomass combustion may be associated with elevated blood pressure (BP).Objective: Our aim was to assess the relationship between air pollution exposure from indoor biomass combustion and BP in women in rural China.Methods: We measured 24-hr personal integrated gravimetric exposure to fine particles < 2.5 µm in aerodynamic diameter (PM_2.5) and systolic BP (SBP) and diastolic BP (DBP) in the winter and summer among 280 women ≥ 25 years of age living in rural households using biomass fuels in Yunnan, China. We investigated the association between PM_2.5 exposure and SBP and DBP using mixed-effects models with random intercepts to account for correlation among repeated measures.Results: Personal average 24-hr exposure to PM_2.5 ranged from 22 to 634 µg/m³ in winter and from 9 to 492 µg/m³ in summer. A 1-log-µg/m³ increase in PM_2.5 exposure was associated with 2.2 mm Hg higher SBP [95% confidence interval (CI), 0.8 to 3.7; p = 0.003] and 0.5 mm Hg higher DBP (95% CI, –0.4 to 1.3; p = 0.31) among all women; estimated effects varied by age group. Among women > 50 years of age, a 1-log-µg/m³ increase in PM_2.5 exposure was associated with 4.1 mm Hg higher SBP (95% CI, 1.5 to 6.6; p = 0.002) and 1.8 mm Hg higher DBP (95% CI, 0.4 to 3.2; p = 0.01). PM_2.5 exposure was positively associated with SBP among younger women, but the association was not statistically significant.Conclusion: PM_2.5 exposure from biomass combustion may be a risk factor for elevated BP and hence for cardiovascular events. Our findings should be corroborated in longitudinal studies.     

Randomized Trial on the Effects of Dietary Potassium on Blood Pressure and Serum Potassium Levels in Adults with Chronic Kidney Disease

In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing 100 and 40 mmol K/day on BP in 29 adults with stage 3 CKD and treated or untreated systolic BP (SBP) 120–159 mmHg and diastolic BP (DBP) <100 mmHg. The primary outcome was 24 h ambulatory systolic BP. The higher-versus lower-K diet had no significant effect on 24 h SBP (−2.12 mm Hg; p = 0.16) and DBP (−0.70 mm Hg; p = 0.44). Corresponding differences in clinic BP were −4.21 mm Hg for SBP (p = 0.054) and −0.08 mm Hg for DBP (p = 0.94). On the higher-K diet, mean serum K increased by 0.21 mmol/L (p = 0.003) compared to the lower-K diet; two participants had confirmed hyperkalemia (serum K ≥ 5.5 mmol/L). In conclusion, a higher dietary intake of K did not lower 24 h SBP, while clinic SBP reduction was of borderline statistical significance. Additional trials are warranted to understand the health effects of increased K intake in individuals with CKD.