| Objective1. Effect of potassium-enriched salt on blood pressure in hypertensive patients.2. Effect of potassium-enriched salt on arterial stiffness in hypertensive patients.3. Effect of potassium-enriched salt on vascular endothelial function in hypertensivepatients.4. Safety assessment of potassium-enriched salt in hypertensive patients.5. Compliance review of potassium-enriched salt used in people group.MethodsThe research objects were volunteer participants (n=308) eligible to potassium-enrichedsalt test after cluster sampling and baseline survey selected from families in QingheCounty of Hebei Province. All people were divided into common salt group (CSgroup) and potassium-enriched salt group (PES group) according to family by usingsingle blind method. CS group was given common salt (with99%NaCl) and PESgroup was given high-potassium and low-sodium salt (mass ratio: NaCI︰KCI=1︰1).The health education of limit salt diet was carried out in two groups. One year afterbaseline survey and intervention, all people were given questionnaire, blood pressuredetection and determination of pulse wave velocity (PWV) during reexamination, andthe samples of blood and urine were collected from them. The serum indexesreflecting vascular endothelial function—nitric oxide (NO) and endothelin-1(ET-1), and indexes reflecting early kidney function—cystatin C were detected. The levels ofurine microalbumin (mAlb) and creatinine (Cr) were determined. At the end of thetest, the taste of two kinds of salt and insistence of eating were investigated. Afterintervention for one year, the data of93patients with baseline hypertension, who stuckto supplied salt and having complete materials, were counted and analyzed. Allmaterials were input in the database established with EpiData3.1software, and thesurvey data were input twice respectively by two groups of researchers, and givenconsistency test for insuring accuracy. The measurement data were counted andanalyzed by using SPSS17.0statistical software, and measurement data were indicatedas mean±standard deviation (±s) and utilization rate of enumeration data were indicatedas rate (%). The independent sample t-test was applied in the comparison ofmeasurement data between two groups, paired data t-test was applied in the comparisonof the same group before and after intervention. The χ2test was used in thecomparison of enumeration data, and P<0.05meant that difference was statisticallysignificant.Results1. General features of CS group and PES group at baselineThe comparison in age, height, weight, body mass index (BMI), systolic pressure,diastolic pressure, PWV and indexes of blood and urine had no statistical differencesbetween two groups at baseline (P>0.05). The comparison of enumeration datashowed that there was no statistical differences in sex, smoking history, drinking history,degree of education and drug taking between two groups (P>0.05).2. Changes of blood pressure in CS group and PES group after intervention2.1Throughout the study, systolic pressure had a trend of descending→ascending→stable, and diastolic pressure had a trend of descending→ascending→ re-descending in two groups. In the each stage of whole follow-up period, the changesof blood pressure had no statistical difference between two group (P>0.05).2.2After a long-term (one year) changes of sodium (Na) and potassium (K) content indiet, the blood pressure in CS group had no changes before and after intervention(P>0.05), while in PES group systolic pressure and diastolic pressure descendedrespectively7.9mm Hg and3.6mm Hg compared with baseline (P<0.05). Thecomparison of blood pressure had no statistical difference between two groups (P>0.05)after intervention.3. Changes of arterial stiffness in CS group and PES group after interventionIn CS group and PES group, cfPWV was, respectively,9.55±2.13m/s and9.90±1.97m/s at baseline, and9.21±1.66m/s and9.18±1.75m/s after one year, descending0.34m/s and0.71m/s respectively. The comparison showed that CS group had nostatistical difference and PES group had statistical difference (P<0.05) before and afterintervention. The comparison between tow groups had no statistical difference(P>0.05) after intervention.4. Changes of vascular endothelial function in CS group and PES group afterinterventionAfter intervention for one year, serum levels of No and ET-1were, respectively,5.31±3.27umol/L and1.69±0.92ug/L in CS group, and7.24±4.13umol/L and1.27±0.94ug/L in PES group (P<0.05).5. Safety assessment of potassium-enriched salt in hypertensive patientsAfter intervention for one year, the levels of serum GPT, Cr, cystatin C, Na and K werein normal range in two groups. After independent sample t-test between two groups,all indexes had no statistical differences (P>0.05) besides of the level of serum K hadstatistical difference in PES group (P<0.05), but the highest level of serum K was5.11mmol/L which was in the normal range. There were no patients with hyperkalemia. The ratio of mAlb to Cr had no statistical difference between two groups (P<0.05?).There were no cases with adverse reactions after taking potassium-enriched salt in thestudy.6. Compliance review of potassium-enriched salt used in people groupAmong all objects,280(91%) insisted to eat supplied salt,15(5%) insisted to eat at parttime, and13(4%) did not insist to eat (quitting). In CS group the objects who insistedto eat supplied salt accounted for87%and in PES group,96%. In the evaluation onsalt taste by subjects in two groups,71.3%in CS group and70.9%in PES group felt thesalt good and indifferent,17.7%in CS group and20.5%in PES group felt good and alittle different, and11%in CS group and8.7%in PES group felt not as good as originalsalt and a little different.Conclusion1. Long-term eating of potassium-enriched salt can to some extent decrease the level ofblood pressure in hypertensive patients.2. Long-term eating of potassium-enriched salt can to some extent slow the speed ofaorta artherosclerosis in hypertensive patients.3. Long-term eating of potassium-enriched salt can to some extent protect vascularendothelial function in hypertensive patients.4. Potassium-enriched salt has higher safety and compliance when it used in peoplegroup, and it is suitable for application and dissemination in general population in viewof features of hypertension occurrence and high-salt diet of residents in our country. |
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