食用18%限钠配方盐对社区高血压人群家庭自测血压的影响  

The effect of 18% sodium-restricted formula salt on home blood pressure in community hypertension patients

作　　者：王梅仙 武阳丰[2] 刘婷 解武祥[2] 饶华坤 王文 李革[1] 牟李红[1] WANG Mei-xian;WU Yang-feng;LIU Ting;XIE Wu-xiang;RAO Hua-kun;WANG Wen;LI Ge;MU Li-hong(School of Public Health and Management,Chongqing Medical University,Research Center for Medicine and Social Development,Collaborative Innovation Center for Social Risk Prediction and Governance in Health,Chongqing 400016,China;不详)

机构地区：[1]重庆医科大学公共卫生与管理学院,流行病学,医学与社会发展研究中心,健康领域社会风险预测治理协同创新中心,重庆400016 [2]北京大学临床研究所 [3]重庆市南岸区人民医院

出　　处：《中华高血压杂志》2019年第11期1041-1046,共6页Chinese Journal of Hypertension

基　　金：“十三五”国家科技支撑项目“心脑血管疾病营养及行为干预关键技术及应用策略研究”(2016YFC1300200)

摘　　要：目的探讨18%限钠配方盐对原发性高血压患者家庭自测血压的影响及患者接受意愿的分析。方法本试验采用自身前后对照试验设计。2018年5-7月,纳入某医院辖区建档的高血压患者,患者家庭采用18%限钠配方盐全程替代其他食用盐干预8周,干预期间及干预结束后4周患者每天使用统一型号的上臂式家庭远程智能血压仪进行血压监测,干预前后分别收集患者24 h尿测尿钠、尿钾,每周入户随访1次,收集降压药物、不良反应事件及限钠配方盐相关信息。干预后期对所有患者进行定性访谈,了解患者对该配方盐的口感和接受意愿。结果共纳入43名受试对象,失访4人,失访率9.3%。干预8周后,清晨收缩压与舒张压分别由基线的(138.4±18.9)/(76.8±9.6)降至(125.6±12.1)/(72.3±9.0)mm Hg,晚间收缩压与舒张压也分别由(135.9±16.1)/(74.5±8.9)降至(124.0±10.7)/(70.1±8.5)mm Hg(均P<0.05)。停用配方盐4周后与干预第8周相比,清晨收缩压与舒张压分别上升了4.7、2.8 mm Hg,晚间收缩压与舒张压分别上升了5.0、3.0 mm Hg(均P>0.05)。干预后,共计12例调整降压药物,其中7例减药,5例停药,减药率17.9%,停药率12.8%。干预前后尿钠变化虽差异无统计学意义,但尿钾由(52.2±19.3)上升到(61.0±17.3)mmol/24 h(P<0.05),尿钠/钾由3.3(2.8~3.7)降到2.4(2.0~2.9)(P<0.01)。87.2%的患者认为该盐有涩味或芳香味,但仍有84.6%的患者表示在适应一段时间后能够接受该盐口感;59.0%的患者表示愿意长期食用这款配方盐,主要原因为该盐降压效果好;17.9%的患者主要由于该盐口感不佳而不愿意长期食用;还有23.1%的患者虽接受口感但仍持中立态度。整个研究期间无严重不良事件发生。结论初步观察,该18%限钠配方盐能够有效控制血压,患者普遍认同其降压效果,但其口感有待进一步改善。Objective To investigate the effect of 18%sodium-restricted salt on the self-test home blood pressure in patients with essential hypertension and their willingness to accept it.Methods This test was a preliminary self-control study.Patients with established records in a community under the jurisdiction of a hospital were enrolled from May 2018 to July 2018.The 18%sodium-restricted formula salt replaced the regular salt in the patient’s family.The intervention was carried out for 8 weeks.During this period and 4 weeks after the intervention,the blood pressure was monitored daily using unified upper-arm blood pressure monitor.Before and after the intervention,24-hour urine was collected for urinary sodium and potassium measurement.The patients were followed up once a week to collect information on antihypertensive drugs and sodium-restricted formula salts.At the end of the trial,all patients were interviewed to investigate the patients’acceptance of the taste of 18%sodium-restricted salt.Results A total of 43 hypertensive patients were enrolled.4(9.3%)patients were lost during follow-up.After 8 weeks of intervention,the morning systolic and diastolic blood pressure decreased from(138.4±18.9)/(76.8±9.6)to(125.6±12.1)/(72.3±9.0)mm Hg,and the evening systolic and diastolic pressures from(135.9±16.1)/(74.5±8.9)to(124.0±10.7)/(70.1±8.5)mm Hg respectively(both P<0.05).Four weeks after discontinuation of formula salt,compared with week 8 of intervention,the morning systolic and diastolic blood pressure increased by 5.0 and 3.0 mm Hg respectively(both P>0.05).After the intervention,Antihypertensive drugs were adjusted in 12 people,and reduced in 7,discontinued in 5.The drug reduction rate was 17.9%,and the drug withdrawal rate was 12.8%.There was no statistical difference in urinary sodium before and after intervention,but urinary potassium increased from(52.2±19.3)to(61.0±17.3)mmol/24 h(P<0.05),and the urinary sodium/potassium ratio decreased from 3.3(2.8-3.7)to 2.4(2.0-2.9)(P<0.01).87.2%of the patients thou

关 键 词：18%限钠配方盐 高血压 口感 意愿分析 

分 类 号：R544.1[医药卫生—心血管疾病]