新型低钠复合离子盐降压作用的社区人群干预研究  

Efficacy and Safety of a Novel Low Sodium Compound Ion Salt on Blood Pressure Control in a Community Based Population Trial

作　　者：周欣[1] 刘军翔[1] 石蕊[1] 杨宁[1] 宋冬林[1] 庞伟[1] 李玉明[1] 

机构地区：[1]中国人民武装警察部队医学院附属医院心血管内科,武警部队心血管病研究所,天津300162

出　　处：《中华高血压杂志》2009年第6期546-552,共7页Chinese Journal of Hypertension

基　　金：国家自然科学基金(30871072和30740010);天津市科委重大科技攻关项目(023181411)

摘　　要：目的通过社区人群干预,观察新型低钠复合离子盐(CISalt)降压作用的有效性、安全性以及人群依从性。方法采用随机、对照、单盲设计,248名入选对象选自天津10个社区,平均年龄≥65岁的老年人,分别给予CISalt和普通盐进行饮食干预。每两月随访血压一次,共6月。测定试验开始和随访结束时的相关血液生化指标、24h尿电解质和血浆肾素活性等。结果与普通盐组比较,CISalt组在第2月随访时血压即呈现下降趋势,于第4月随访时,收缩压下降6.7mmHg(95%CI:-10.3～-3.1,P<0.01);舒张压下降2.6mmHg(95%CI:-5.5～0.2,P=0.07)。随访6月末,CISalt的收缩压较对照组降低9.6mmHg(95%CI:-13.1～-6.1,P<0.01),舒张压降低5.3mmHg(95%CI:-7.9～-2.6,P<0.01),24h尿钠量减少67.4mmol(95%CI:-84.8～-50.0,P<0.01);而前者的血浆肾素活性较对照组升高0.19μg/(L.h)(95%CI:0.04～0.33,P=0.013)。随访期间未出现明显不良反应,无不良心血管事件发生。结论CISalt能有效降低老年高盐摄入人群的血压水平,且有良好的长期依从性及无不良反应,使CISalt有良好的在人群中应用的前景。Objective To investigate the efficacy, safety and compliance of a novel compound ion salt （CISalt） with low sodium content in community-based populations. Methods We conducted a single blinded, randomized controlled trial in 248 aged persons （average age ≥ 65 years） in 10 rural communities of Tianjin for 6 months. Blood pressure （BP） was measured every two months. The plasma renin activity and Ang Ⅱ and other related blood and urinary parameters were measured at the beginning and in the end. Results Compared with control group, there was a continuously decreasing trend for BP in CISalt group from the end of 2 month, and the mean net decrease for BP lowering at the end of 4 month were 6.7mmHg （95% CI： -10.3 to -3.1, P〈0.01） for SBP, and 2.6 mmHg （95 % CI： -5.5 to 0.2, P=0.07） for DBP. At the end of follow-up, compared with the controls, meanSBP in CISalt group was decreased by -9.6 mmHg （95% CI： -13.1 to -6.1, P〈0.01） and DBP by -5.3 mmHg （95% CI： -7.9 to -2.6, P〈0.01）, respectively; the urinary sodium excretion also was decreased by -67.4 mmol/24 h （95% CI： -84.8 to -50.0, P〈0.01）, associated with increased plasma renin activity by 0.19 μg/（L · h） （95 % CI： 0. 04 to 0.33, P-0. 013）. No adverse cardiovascular events were reported during the follow ups. Conclusions The studyclearly demonstrated that CISalt lowered BP in a population with previous high salt intake. Long term compliance without obvious side effects of CISalt shows its promising prospect in population application.

关 键 词：高血压 限盐 随机对照试验 

分 类 号：R544.1[医药卫生—心血管疾病]