低钠富钾替代盐对农村社区人群血压影响的现场观察

Field observation on the effect of low-sodium and high-potassium salt substitute on blood pressure in the rural community-based population in China

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24h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7．4mmHg（1mmHg=0．133kPa；f=10．096，P=0．000），舒张压（DBP）下降3．8mmHg（t=8．017，P=0．000）；非高血压组SBP平均下降1．2mmHg（t=2．507，P=0．007），DBP下降1．0mmHg（t=2．987，P=0．002）。干预3个月后评估时高血压组24h尿钠平均下降15．5mmol（t=1．803，P=0．037），尿钾上升4．2mmol（t’=2，132，P=0，018），钠钾比下降1.2（t=2．786，P=0．003）；非高血压组24h尿钠平均下降1．7mmol（t=0．211，P=0．417），尿钾上升3．7mmol（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。

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 mm 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 retool/24 h （t＇ =2.207, P=0.015）, together with the decrease of Na＋/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.