| Background and ObjectiveAccording to the latest health data from the World Health Organization:The number of patients with hypertension has reached 27%of the global population.It is a major risk factor that endangers human health and life,including stroke,heart failure,sudden death,and kidney damage.The incidence of blood pressure-related diseases and complications is on the rise.The blood pressure level of normal people will fluctuate according to the daily life and rest situation,and it is usually higher during the day and lower at night.This regulation of blood pressure circadian rhythm has protective effects on target organs such as heart,kidney,and brain.Hypertension patients with abnormally high blood pressure,leading to decreased vascular elasticity,activation of the neuro-humoral regulation system,resulting in abnormal regulation of blood pressure,more prone to changes in blood pressure circadian rhythm,thereby promoting increased atherosclerosis,impaired renal function,etc.Blood pressure levels are closely related to dietary salt intake.High sodium and low potassium diets in our population are important risk factors for hypertension.The methods of evaluating salt intake mainly include 24h urinary sodium and potassium excretion.Studies have shown that 24h urine sodium levels are related to blood pressure rhythm,and the urine sodium-to-potassium ratio is an independent risk factor for cardiovascular events.There are large sample data showing that serum sodium-potassium ratio is positively correlated with blood pressure.Study on the urine sodium-potassium ratio and blood pressure rhythm investigates the effect of serum sodium-potassium ratio and 24-hour urine sodium-potassium ratio on blood pressure rhythm in patients with essential hypertension.Materials and methods1.Objectives:A retrospective analysis of patients with essential hypertension who were continuously hospitalized in the Second Affiliated Hospital of Zhengzhou University from September 2017 to June 2019.For the diagnosis of hypertension,refer to the "China Hypertension Prevention Guide 2018" diagnostic criteria:systolic blood pressure ?140 and/or diastolic blood pressure?90mmHg(1mmHg=0.133kPa),or those who have been diagnosed as having normal blood pressure after taking hypertension.2.Grouping method:The blood pressure rhythm was evaluated by the night blood pressure drop rate.During the day,6:00-22:00 is used as the day time,and other time is used as the night time.The percentage decrease in nighttime blood pressure>10%is defined as dipper-type blood pressure,and the percentage decrease in night-time blood pressure?10%is defined as non-dipper blood pressure.3.Statistical method:SPSS 21.0 statistical analysis software was used.The measurement data were expressed as X±s and they met the normal distribution.Independent sample test was used for comparison between groups;count data was expressed as a percentage,and comparison between groups was tested by ?2.Determine the serum sodium-potassium ratio and 24h urine sodium-potassium ratio and blood pressure.The relationship between rhythms uses the ROC curve.Results(1)A total of 706 patients with primary hypertension were consecutively treated.Secondary hypertension was excluded and patients who were taking antihypertensive drugs and incomplete data were excluded.The final analysis included 264 cases,including 147males and 117 females.The average age was(61±18)years.Compared with general clinical data,patients in the non-dipper blood pressure group are older,more male,have a higher body mass index(BMI),higher fasting blood glucose,and homocysteine compared with those in the dipper blood pressure group.The higher the acid,the higher the prevalence of coronary heart disease.Comparison of the two groups of triglyceride,low density lipoprotein cholesterol(LDL-C),estimated glomerular filtration rate(eGFR),and ejection fraction(EF%)The difference was not statistically significant(P>0.05).(2)After adjusting for age,gender,and BMI,the serum sodium level was significantly increased and the serum potassium level was significantly lower in the non-dipper type blood pressure group compared with the dipper type blood pressure group(P<0.05);large left ventricular mass index and left atrial inner diameter are larger(P<0.05).There was no significant difference between the 24h urine sodium and 24h urine potassium and the non-dipper type blood pressure group(P>0.05).After adjusting for age,gender,and BMI,the serum sodium-to-potassium ratio and 24-hour urine sodium-to-potassium ratio in the non-blood pressure group were significantly higher than those in the non-blood pressure group(P<0.05).(3)After excluding confounding factors including age,gender,BMI,homocysteine,coronary heart disease history,left ventricular mass index,left atrial inner diameter and other indicators,binary logistic multivariate analysis was used to exclude other confounding factors affecting blood pressure rhythm.Previous studies have shown that there is a correlation between serum sodium-potassium ratio and 24h urine sodium-potassium ratio;the market-making quality index has correlation with the left atrial inner diameter.The abnormality of blood pressure rhythm was used as the dependent variable(assignment:non-type blood pressure 1,blood pressure type 0).Blood sodium-potassium ratio,BMI,homocysteine,gender,age,history of coronary heart disease(assignment:none=0,yes=1),left ventricular mass index as independent variable constitutes model 1;24h urine sodium-potassium ratio,BMI,Homocysteine,gender,age,history of coronary heart disease(assignment:none=0,yes=1),left ventricular mass index as independent variable constitutes model 2;blood sodium-potassium ratio,BMI,homocysteine,gender,age,history of coronary heart disease(assignment:no=0,yes=1),left atrial diameter as independent variable constitutes model 3;24h urine sodium-potassium ratio,BMI,homocysteine,gender,age,history of coronary heart disease(Assignment:None=0,Yes=1)The inner diameter of the left atrium is the independent variable that constitutes Model 4.Results:After excluding confounding factors,blood sodium-potassium ratio and 24h urine sodium-potassium ratio were independent risk factors for abnormal blood pressure rhythm P<0.05).(4)ROC curve showed that the area under the curve(95%CI)of serum sodium-potassium ratio and 24h urine sodium-potassium ratio were 0.743(0.713,0.827)and 0.569(0.417,0.613),respectively,and the area under the curve was greater than 0.5(P<0.05);cutoff values were 36.724 and 5.83;specificity was 77.0%and 54.2%;sensitivity was79.1%and43.6%;results:serum sodium-potassium ratio was an independent risk factor for non-type BP blood pressure.Conclusion1.Serum sodium-potassium ratio and 24h urine sodium-potassium ratio are independent risk factors affecting blood pressure rhythm;2.Serum sodium-potassium ratio is an independent predictor of blood pressure rhythm;3.Left ventricular mass index and left atrial diameter were related to blood pressure rhythm. |
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