BMJ:减少饮食中钠摄入量和持续时间对血压水平的影响

2020-02-26 xing.T MedSci原创

由此可见,降低钠摄入与血压降低的幅度呈剂量反应关系,对于老年人、非白人和血压较高的人群降压幅度更大。短期研究低估了降低钠摄入对血压的影响。

近日,顶级杂志BMJ上发表了一篇研究文章,该研究旨在评估饮食中钠的减少与血压变化之间的剂量反应关系,并探讨干预时间的影响。

研究人员按照PRISMA指南进行系统评价和荟萃分析。截至2019年1月21日,研究人员检索了Ovid MEDLINE(R)、EMBASE和Cochrane对照试验中心(Wiley)以及相关文献的参考文献。研究人员纳入了比较成人人群中不同钠摄入量与使用24小时尿钠排泄量估算摄入量的随机试验。三位审阅者中有两位独立审查了记录是否符合标准。一位审核者提取了所有数据,另外两位审核者对数据进行了准确性检查。研究人员进行了随机效应的荟萃分析、亚组分析和荟萃回归。

该分析纳入了133项研究,涉及12197名参与者。24小时尿钠、收缩压(SBP)和舒张压(DBP)的平均减少量分别为130 mmol(95%置信区间为115至145,P<0.001)、4.26 mmHg (3.62至4.89,P<0.001)和2.07 mmHg(1.67至2.48,P<0.001)。24小时钠排泄量每降低50 mmol,SBP降低1.10 mmHg(0.66至1.54; P<0.001),DBP降低0.33 mmHg(0.04至0.63; P=0.03)。在所检查的各种人群中,包括高血压和非高血压个体,均观察到血压降低。对于24小时尿钠同样减少的老年人、非白人基线SBP较高,SBP降幅更大。在持续时间少于15天的试验中,24小时尿钠排泄量每减少50 mmol,SBP下降1.05 mmHg(0.40至1.70;P=0.002),其效应是持续时间较长的研究中观察的一半(2.13mmHg;0.85至3.40;P=0.002)。否则,试验持续时间与SBP降低之间没有关联。

由此可见,降低钠摄入与血压降低的幅度呈剂量反应关系,对于老年人、非白人和血压较高的人群降压幅度更大。短期研究低估了降低钠摄入对血压的影响。

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    2020-12-04 lmm397
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    2020-03-13 gaoxiaoe
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    2020-02-28 zhwj
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