| Background and objectiveHypertension is the world’s popular major chronic diseases. According to the latest research results in 2014,the prevalence rate of hypertension had already reached 29.6% in adult in our country. The result indicated that there were a third of people suffering from hypertension almostly. Hypertension, which can lead to a series of serious complications in both great vessels and microvascular is the important reason for the morbidity and mortality of cardiovascular disease,especially in heart and cerebral vessels and greatly endanger human health and increase the risk of death. Lifestyle and environmental factors are great influences for hypertension. High salt diet and obesity are both risk factors for hypertension and they are closely associated with cardiovascular and cerebrovascular diseases. According to Thereportonchronic disease risk factor surveillance in China 2010, the average salt intake was as high as 10.6g per day in Chinese people and this salt inake level was significantly high than 6g/d which was recommended by 2010 Chinese guidelines for the management of hypertension. Meanwhile, the incidence of obesity has increased significantly in recently years. The study from Marie and her colleagues had shown that the overweight and obese patients had reached 2.1 billion in the world and overweight and obese patients accounted for 30% of the world’s population. Under the above background, researching the salt intake in patients of obesity related hypertension has significant implications for the prognosis of patients with hypertension. High salt diet and obesity are both important risk factor for hypertension disease, but only few research illuminated that high salt diet and obesity influenced on blood pressure and the relationship between the above two factors when both two factors existed simultaneously. Our study aims to research the salt intake in patients of obesity related hypertension, also aims to influences of obesity and salt intake on blood pressure. Through the above research, we could provide references for prevention and control of hypertension.Subjects and methods1.Subjects: Recruiting 399 patients of hypertension during the 2012 September to 2014 June(male 194 cases and female 205 cases),the age distribution were 15~87 years old and the average age is 52±15 years old.2.Methods:(1) general information of hypertension patients were collected;(2) Clinical blood pressure were measured three times, the average systolic blood pressure(SBP) and diastolic blood pressure(DBP) values were taken;diagnostic criteria of hypertension was taken by Chinese guidelines for the management of hypertension.(3) The height and weight of the patients were measured by specially-assigned person and body mass index(BMI=weight(kg)/height2(m2)) were calculated;The diagnostic criteria ofoverweight and obesity were taken by WHO.(4) Waist circumference(WC) of patients were measured by specially-assigned person;the diagnostic criteria ofabdominal obesity were takenby The expert consensus of Chinese adult obesity prevention and treatment.(5) The 24-hour urine of patients were collected and the 24-hour urinary sodium excretion value were measured in clinical laboratory. According to the formula,we calculated the patient’s average salt intake per day(salt intake(g/d)= 24-hour urinary sodium excretion value(mmol/l)×24-hour urinary volume(l)×Na Cl molecular Weight /1000).Results1.General information :The average salt intake of all the hypertension patients is 11.29±5.82 g/d(male 11.27±5.34 g/d, female 11.30±6.25 g/d),there have no significant difference in the average of waist circumference, weight, BMI, 24-hour urinary sodium excretion value and salt intake between male and female. Based on the tangent point 6 g/d of salt intake,Only less than 20% of the patients reached the recommended standard of salt intake.Divided the obese degree by BMI, the detection rate of overweight and obesity in female patients was significantly higher than male patients(P=0.037).Divided the degree of abdominal obesity by waist circumference, the detection rate of abdominal obesity in female patients was significantly higher than male patients(P<0.01).2.The relationship between salt intake and blood pressure: Both SBP(r=0.987) and DBP(r=0.363) levels were significantly positively related to salt intake(P<0.001). Divided the patients by gender, this difference was only existed in female(r=0.847,patients, but the cause-and-effect relationship between the salt and obesity deserves further study. r=0.710,P<0.001,P<0.001).3.The relationship between the index of obesity and blood pressure: Both SBP and DBP levels were significantly positively related to weight.(r=0.406,r=0.620,P<0.05). Divided the patients by gender, this difference was only existed in female(r=0.501,r=0.743,P<0.05).4.The relationship between the degree of obesity and salt intake level: Divided into the normal weight group and overweight and obesity groupby BMI level, in totality, male and female patients, the salt intake of overweight and obesity group were significantly higher than normal weight group(P<0.01). Divided into abdominal obesity and non- abdominal obesity by WC, in totality and female patients, the salt intake of abdominal obesity patients were significantly higher than non- abdominal obesity(P<0.01).WC, weight and BMI were significantly positively related to salt intake in totality, male and female patients(P<0.05).5.The influences of different degree between obesity and salt intake on blood pressure: According to the median average of daily salt intake, all patients were divided into two groups(lowintermediate salt intake group and high salt intake group). In high salt intake group, the SBP and DBP levels of patients with overweight and obesity were significantly higher than the normal weight patients(P<0.05). Divided the patients by gender, the difference was only found in females(P<0.05). In patients with overweight and obesity, the SBP and DBP levels of high salt intake group were significantly higher than the lowintermediate salt intake group(P<0.001). Divided the patients by gender,, in female patients with overweight and obesity, the SBP and DBP levels of high salt intake group were significantly higher than the lowintermediate salt intake group(P<0.001).Conclusion::1.The blood pressure level was significantly and positively related to the levels of salt intake and obesity in the hypertension patients.2.In hypertension patients, the degree of obesity and salt intake have superimposed effect on blood pressure, which is more obvious in female patients. The water-sodium retention may the important mechanism of the above superposition action.3.The levels of obesity and salt intake may have a certain relationship in hypertension... |
