天津市成人24 h尿钠水平与高血压的相关性研究

Correlation between 24-hour urinary sodium level and the risk of hypertension in adult residents of Tianjin

目的了解天津市成人尿钠水平与高血压患病风险的关联,为高血压及相关疾病的防治提供依据。方法本研究数据来自天津市2018年成人慢性病与营养监测,采用多阶段整群随机抽样方法,抽取4423名≥18岁的常住居民进行相关研究。通过问卷调查收集调查对象的人口学特征,通过体格测量收集调查对象的高血压患病等情况,并以晨尿检测结果为点尿钠水平估算24 h尿钠水平。采用SPSS 24.0进行t检验、方差分析、多重线性回归和多因素logistic回归分析。结果加权后,研究对象的高血压患病率为39.8%,单纯收缩期高血压患病率为19.7%,单纯舒张期高血压患病率为3.3%;收缩压中位数为134.00 mm Hg(P_(25)~P_(75):121.00~148.00 mm Hg),舒张压中位数为80.33 mm Hg(P_(25)~P_(75):72.33~88.33 mm Hg);24 h尿钠水平中位数为211.45 mmol/d(P_(25)~P_(75):173.13~254.36 mmol/d)。高血压、单纯收缩期高血压、单纯舒张期高血压患者24 h尿钠水平均高于相应的非患病人群,差异均有统计学意义(P<0.01)。多重线性回归分析调整相关因素后结果显示,24 h尿钠与收缩压(β=0.17)和舒张压(β=0.13)均呈正相关。多因素logistic回归分析结果显示,调整性别、年龄、教育程度、饮酒、吸烟、高血压家族史、BMI和糖尿病后,与24 h尿钠水平最低四分位数组相比,尿钠水平最高四分位数组患高血压、单纯收缩期高血压的风险较高,OR值分别为2.15(95%CI:1.74~2.65)、1.61(95%CI:1.25~2.08),均有统计学意义(P<0.01),单纯舒张期高血压的患病风险无统计学意义(OR=1.23,95%CI:0.73~2.08,P>0.05)。结论24 h尿钠水平与高血压、单纯收缩期高血压存在关联,应开展有效的干预和广泛的科普宣传,降低广大群众的食盐摄入量。

Objective To understand the correlation between 24-hour urinary sodium level and hypertension for adult residents in Tianjin,and provide the evidence for the prevention and treatment of hypertension and related diseases.Methods The data were from″Adult Chronic Diseases and Nutrition Monitoring of Tianjin″in 2018,the multi-stratified clustering sampling method was used to select 4423 residents(≥18 years old)as the subjects.The investigation was performed with the questionnaire to collect the demographic characteristics of the subjects,the physical examination was conducted to collect the morbidity of hypertension,and the results of morning urine test served as the point urinary sodium to estimate 24-hour urinary sodium level.The t test,analysis of variance and the multivariate linear regression and logistic regression analysis were used to analyze the data.The used software was SPSS 24.0.Results After the weighting,the morbidity rates of hypertension,isolated systolic hypertension and isolated diastolic hypertension were 39.8%,19.7%and 3.3%,respectively.The median of systolic blood pressure was 134.00 mm Hg(P_(25)-P_(75):121.00-48.00 mm Hg),and the median of diastolic blood pressure was 80.33 mm Hg(P_(25)-P_(75):72.33-88.33 mm Hg).The median 24 h urinary sodium level was 211.45 mmol/d(P_(25)-P_(75):173.13-254.36 mmol/d).The median of 24 h urinary sodium levels of patients with hypertension,isolated systolic hypertension and isolated diastolic hypertension were significantly higher than those of the corresponding non-patients(P<0.01).Multivariate linear regression analysis showed that 24 h urinary sodium level was positively correlated with systolic blood pressure(β=0.17)and diastolic blood pressure(β=0.13)after adjusting for related factors.Multivariate logistic regression analysis showed that after adjusting for gender,age,education,drinking,smoking,family history of hypertension,body mass index and diabetes,as compared to population in the lowest quantile,population in the highest quantile group had an increased risk of hypertension and isolated systolic hypertension,OR values were 2.15(95%CI:1.74-2.65)and 1.61(95%CI:1.25-2.08),respectively(P<0.01),and the risk of isolated diastolic hypertension was not statistically significant(OR=1.23,95%CI:0.73-2.08,P>0.05).Conclusion The 24 h urinary sodium level is independently correlated with hypertension and isolated systolic hypertension.Effective intervention and extensive popular science propaganda should be carried out to reduce the salt intake of the masses.