Effect of salt substitution on community-wide blood pressure and hypertension incidence.
Effect of salt substitution on community-wide blood pressure and hypertension incidence.
复制标题
DOI：
10.1038/s41591-020-0754-2
复制
发表时间：
2020-03
期刊：
影响因子：
82.9
通讯作者：
Miranda JJ
中科院分区：
文献类型：
--
作者：
Bernabe-Ortiz A;Sal Y Rosas VG;Ponce-Lucero V;Cárdenas MK;Carrillo-Larco RM;Diez-Canseco F;Pesantes MA;Sacksteder KA;Gilman RH;Miranda JJ
在受控情况下，用富钾替代品取代普通盐可以降低血压，主要是在高血压患者中。我们在阶梯式楔形群随机试验(NCT01960972)中报告了该策略在整个人群中的实施情况。被登记家庭的普通盐被回收，并用75%的氯化钠和25%的氯化钾的组合免费更换。共有2376名参与者在秘鲁通贝斯的六个村庄登记参加。完全调整的意向治疗分析显示，平均收缩压降低1.29毫米汞(95%可信区间[95%CI]-2.17；-0.41)，舒张压平均降低0.76毫米汞(95%可信区间-1.39；-0.13)。在基线没有高血压的参与者中，在时间和集群调整的模型中，与对照组相比，盐替代品的使用与患高血压的风险降低了51%(95%可信区间29%-66%)。在24小时尿样中，钠水平没有差异(平均差异-0.01；95%可信区间-0.25；0.23)，但钾水平在研究结束时高于基线水平(平均差异-0.63；95%可信区间-0.78；-0.47)。我们的结果支持在降低血压和高血压发病率方面实施实用的全人群食盐替代策略。
Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped wedge cluster randomized trial (NCT01960972). The regular salt of enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% of KCl. A total of 2376 participants were enrolled in six villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval [95% CI] -2.17; - 0.41) in systolic and of 0.76 mm Hg (95% CI -1.39; -0.13) in diastolic blood pressure. Among participants without hypertension at baseline, in the time and cluster adjusted model, the use of the salt substitute was associated with a 51% (95% CI 29% - 66%) reduced risk of developing hypertension compared with the control group. In 24-hour urine samples, there was no evidence of differences in sodium levels (mean difference -0.01; 95% CI -0.25; 0.23), but potassium levels were higher at the end of the study compared to those at baseline (mean difference -0.63; 95% CI -0.78; -0.47). Our results support a case for implementing a pragmatic population-wide salt substitute strategy in reducing blood pressure and hypertension incidence.
登录
查看更多内容
影响因子：
6.3
作者：
Bernabé-Ortiz A;Carrillo-Larco RM;Gilman RH;Checkley W;Smeeth L;Miranda JJ;CRONICAS Cohort Study Group
通讯作者：
CRONICAS Cohort Study Group
影响因子：
2.2
作者：
Hughes, James P.;Granston, Tanya S.;Heagerty, Patrick J.
通讯作者：
Heagerty, Patrick J.
影响因子：
105.7
作者：
Campbell, MK;Elbourne, DR;Altman, DG
通讯作者：
Altman, DG
影响因子：
3.7
作者：
Li N;Yan LL;Niu W;Yao C;Feng X;Zhang J;Shi J;Zhang Y;Zhang R;Hao Z;Chu H;Zhang J;Li X;Pan J;Li Z;Sun J;Zhou B;Zhao Y;Yu Y;Engelgau M;Labarthe D;Ma J;MacMahon S;Elliott P;Wu Y;Neal B
通讯作者：
Neal B
影响因子：
56.3
作者：
Durovni, Betina;Saraceni, Valeria;Golub, Jonathan E.
通讯作者：
Golub, Jonathan E.