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。

Field observation on the effect of Iow-sodium and high-potassium salt substitute on blood pressure in ruralcommunity-based population in China

Objective To investigate the effect of commercial low-sodium and high-potassium salt substitutes on blood pressure in the rural community-based population in China.Methods We conducted a quasi-experiment on 411 adults, who were 30 to 60 years of age, in 2 rural communities from Laiwu city in Shandong province of China on data from blood pressure screening.The subjects were divided into 2 groups: high blood pressure (HBP) and non-HBP (NHBP). Both groups and their family members took a low-sodium and high-potassium salt substitute for 3 months to replace the normal salt in their bodies. Blood pressure (BP) and 24-hour urinary sodium and potassium were measured regularly in the 2 groups. Results There was a continuously decreasing trend for BP at the end of the first month. Three months later, the mean BP decreased by 7.4 mm Hg (1 mm Hg=0.133 kPa, t=10.096, P=0.000) for SBP and 3.8 mm Hg (t=8.017, P=0.000) for DBP in the HBP group,when compared to a 1.2 mm Hg(t=2.507,P=0.007) decrease on SBP and 1.0 nun Hg(t=2.987, P=0.002) on DBP in the NHBP group. The mean urinary sodium had a decrease of 15.5 mmol/24 h (t=1.803,P=0.037) ,but the urinary potassium increased by 4.2 mmol/24 h (t' =2.132, P=0.018). The result of urinary sodium appepared to be as follows:potassium ratio (Na+/K+ ) decreased by 1.2 (t=2.786,P=0.003) in the HBP group. However,in NHBP group,the mean urinary sodium decreased by 1.7 mmol/24 h (t=0.211, P=0.417) and urinary potassium increased by 3.7 mmol/24 h (t' =2.207,P=0.015) ,together with the decrease ofNa+/K+ by 0.7 (t=1.818, P=0.036). Conclusion Results from our study clearly demonstrated that the intake of low-sodium and high-potassium salt substitute could effectively reduce the BP with good compliance among adults in the rural community-based population in China. This was an effective but non-medical method to prevent and control the high blood pressure.