Dose-response association of 24-hour urine sodium and sodium to potassium ratio with nighttime blood pressure at older ages
Dose-response association of 24-hour urine sodium and sodium to potassium ratio with nighttime blood pressure at older ages
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DOI：
10.1177/2047487318819528
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发表时间：
2019-06-01
影响因子：
8.3
通讯作者：
Jo, Sang-Ho
中科院分区：
文献类型：
--
作者：
Kim, Mi Kyung;Kwon, Minji;Jo, Sang-Ho
目的：研究24小时尿钠和钾与24小时动态血压的剂量反应关系。设计以社区为基础的横断面研究。方法在社区横断面调查的1128名参与者中，纳入740名具有完整24小时尿液采集和有效24小时动态血压监测的参与者（年龄20-70岁）。参与者分为年轻组（= 55岁，n = 217）。结果老年人夜间血压与24小时尿钠及钠钾比值呈线性关系。对于24小时尿钠，夜间收缩压的校正β为0.171（95%置信区间（CI）0.036-0.305），夜间舒张压为0.144（95% CI 0.012-0.276）。对于24小时尿钠钾比，夜间收缩压校正β为0.142（95% CI 0.013-0.270），夜间舒张压校正β为0.144（95% CI 0.018-0.270）。24小时血压随24小时尿钠钾比线性增加，24小时收缩压和24小时舒张压的校正β分别为0.133（95% CI 0.003-0.262）和0.123（95% CI 0.003-0.244）。在老年人群中，日间血压和24小时收缩压与24小时尿钠呈显著的非线性相关。在年轻人群中，24小时尿钠、钾和钠钾比与动态血压无关。结论在老年人群中，24 h尿钠和钠钾比值与夜间血压呈线性正相关，24 h尿钠与24 h收缩压和日间血压呈非线性相关。
Aims We investigated the dose-response association of 24-hour urine sodium and potassium with 24-hour ambulatory blood pressure. Design Cross-sectional community-based study. Methods Among the 1128 participants in the community-based cross-sectional survey, 740 participants (aged 20-70 years) with complete 24-hour urine collection and valid 24-hour ambulatory blood pressure monitoring were included in the study. Participants were grouped into younger (= 55 years, n = 217). Results In the older population, nighttime blood pressure linearly increased with 24-hour urine sodium and the sodium to potassium ratio. For 24-hour urine sodium, adjusted beta was 0.171 (95% confidence interval (CI) 0.036-0.305) for nighttime systolic blood pressure and 0.144 (95% CI 0.012-0.276) for nighttime diastolic blood pressure. For the 24-hour urine sodium to potassium ratio, adjusted beta was 0.142 (95% CI 0.013-0.270) for nighttime systolic blood pressure and 0.144 (95% CI 0.018-0.270) for nighttime diastolic blood pressure. The 24-hour blood pressure linearly increased with the 24-hour urine sodium to potassium ratio and adjusted beta was 0.133 (95% CI 0.003-0.262) for 24-hour systolic blood pressure and 0.123 (95% CI 0.003-0.244) for 24-hour diastolic blood pressure. Daytime blood pressure and 24-hour systolic blood pressure showed a significant but non-linear association with 24-hour urine sodium among the older population. In the younger population, 24-hour urine sodium, potassium and the sodium to potassium ratio were not associated with ambulatory blood pressure. Conclusion In the older population, 24-hour urine sodium and the sodium to potassium ratio showed a linear and positive association with nighttime blood pressure, and 24-hour urine sodium was associated with 24-hour systolic blood pressure and daytime blood pressure in a non-linear fashion.