摘要
目的观察在原有膳食钠摄入条件下,增加钾和钙摄入量可否起到与减少钠摄入量相同的降压作用。方法在经过8年血压随访的汉中市心血管病防治区4623名青少年中,对其中330名血压偏高者共300个家庭采用随机、单盲、对照的方法分为:(1)补钾、补钙组110名,和其共同生活的家庭成员进行为期2年的对照试验,钾和钙的添加量约为每日10mmol,与食盐混合提供给每个家庭;(2)限盐组110名,通过以家庭为单位进行高血压卫生健康教育,使每日钠摄入量在原有基础上逐渐减少50～100mmol,家用食盐按需要提供;(3)对照组110名,也免费提供家用食盐。随访每半年进行1次,内容包括3天饮食的回顾性调查,夜12小时尿钠、钾排泄量,高血压卫生知识问卷考试,血压、身高及体重的测量等。随访人员均经过血压测量的培训和考试,并进行过多次高血压流行病学调查。盐敏感性判定用静脉盐水负荷法,尿钠、钾测定用火焰光度法。结果两年期血压偏高者的平均随访率为87.4％,家庭总成员的随访率为81.8％;经两年期试验,补钾补钙组血压较基线分别下降了5.9/2.8mmHg。随访发现,补钾和钙半年后血压即呈现降低,1年后最显著;限盐组3天饮食回顾性调查日摄钠量2年后较基线平均减少了54mmol,血压平均下降5.8/2.8mmHg,而对照组则上升了1.3/2.3mmHg;补钾补钙组,2年末随访血压盐敏感者(n=37)下降了9.9/5.5mmHg,明显高于盐不敏感者(n=64),后者仅下降了3.6/1.1mmHg,P<0.01;限盐组中,盐不敏感者的血压较盐敏感者下降显著,较基线分别下降7.9/3.2mmHg和2.2/2.5mmHg。结论在食盐中适量添加钾和钙盐和减少盐的摄入量一样均有助于降低或延缓血压偏高青少年血压的进一步升高,从而达到预防高血压的目的,特别是盐敏感者。
To investigate hypertension - preventive effects of adding potassium and calcium to the diet - salt in adolescents with higher blood pressure (HBP) and their family members, 330 adolescents with HBP, selected from 4623 subjects who have been followed up for 8 years were enrolled, as well as the related 300 families with total family members 651. It was randomly divided into 3 groups: Adding K and Ca group (A) , equally 10 mmol of potassium and calcium per person daily were added to the dietary salt; Restricting - salt group (R), the salt intakes graduallydecreased, the goal was less 50 ~ 100 mmol per day than before and the control group (C) . The salt was supplied freely for the all groups, in addition of K and CA in group A. It was followed up every 6 months for two years, the follow - up rate was 87.4% for adolescents, 81.8% for the family members. The results show: (1) After two years the blood pressure (BP) in group A, compared with the baseline, decreased average 5.9/2.8mmHg (P < 0.01), especially in the salt - sensitivity (SS), 9.9/5.5mmHg (SS, n = 37) vs 3.6/1.ImmHg (non-SS, n=64), P<0.01; In group R, the salt intakes from 3 days retrospective investigation decreased 54 mmol per day than before and the BP decreased 5.8/1.0 mmHg, but in group C the BP increased 1.3/1.4 mmHg. (2) The BP in the family members also decreased average 5.4/3.4 mmHg in group A, 5.6/2.4 mmHg in group R, but in the group C it was increased 1.1/0.9 mmHg. (3) Further delamination analyses show that the blood pressure in the salt sensitivity subjects of group A decreased more than that in the non - SS ( - 9.9/ -5.5 vs - 3.6/1.1 mmHg) . Conclusion Adequate adding potassium and calcium in the dietary salt, similar to the salt restrict effect, would decrease or delay the further blood pressure increase in adolescents with higher blood pressure, especially for the salt sensitivity, and the family members as well.
出处
《医学研究通讯》
2001年第12期9-14,共6页
Bulletin of Medical Research
基金
国家"八五"科技攻关课题
关键词
青少年
高血压
食盐中添加钾和钙
一级预防
Adolescents High blood pressure Calcium potassium diet Primary prevention
