Study On The Relationshipbetween Salt Intake With Target Organ Damage In Elderly Hypertension Patients

Objective:To explore the degree of salt damage to target organs in elderly hypertension patients and its correlation,and to provide assistance for further development of personalized salt-limiting plans and prevention and treatment of elderly hypertension.Methods:A total of 122 elderly patients with hypertension were selected from January 2017 to December 2019 in the Second Affiliated Hospital of Kunming Medical University and Fuwai Cardiovascular Hospital of Yunnan Province.The subjects were divided into three groups based on the amount of 24h urine sodium excretion:low salt group(urine sodium ?100mmol/24h,n=27),medium salt group(100mol/24h<urine sodium?200mmol/24h,n=62)High salt group(urine sodium>200mmol/24h,n=33).Collect gender,age.body mass index(BMI),office systolic blood pressure(SBP)and diastolic blood pressure(DBP),duration of hypertension,medication status and other general information respectively,record the relevant indicators of echocardiography,the results of the arteriosclerosis tester and results of laboratory indicators such as urine microalbumin.According to the results of echocardiography,the left ventricular mass index(LVMI)was calculated.LVMI was used as the index to judge left ventricular hypertrophy(LVH);microalbuminuria(MAU)was used as the index to judge early renal damage;baPWV and ABI were used as the indexes to evaluate the degree of arteriosclerosis,to observe the correlation between different salt intake and left ventricular hypertrophy,microalbuminuria,and arteriosclerosis,and analyze the difference of 24h urine sodium excretion by different antihypertensive drugs.Results:1.There was no difference between the three groups of general information(p>0.05);the mean 24-hour average sodium sodium in different salt intake groups was(66.89 ± 24.63),(141.84 ± 25.19),(244.32 ± 46.5)mmol/24h.The corresponding average salt intakes were(4.35 ± 1.60),(9.22 ± 1.64),and(15.89±3.02)g/d.The difference in 24h urine sodium between the three groups was statistically significant(F=232.44,p<0.01).The difference between the two comparisons was statistically significant(p<0.05);the 24h sodium-potassium ratios in the different salt-taking groups were(2.03 ± 1.03),(3.65 ± 1.34),and(5.48 ± 1.52),and the 24-hour sodium and potassium between the three grroups.The difference in the ratios was statistically significant(F=50.53,p<0.01),and the differences between the two pairs were statistically significant(p<0.05).2.There was no significant difference in LVDD and LVMI between the three groups(p>0.05).The difference of IVST and LVPW among the three groups was statistically significant(p<0.05).IVST and LVPW in the high salt group were higher than those in the low salt group and the medium salt group(p<0.05).Multivariate logistic regression showed that 24-hour urinary sodium and sodium potassium ratios were not the influencing factors of left ventricular hypertrophy.After adjusting for other factors such as SBP,PP,age.Gender was aninfluence factor of left ventricular hypertrophy(OR=0.301.95%CI 0.11?0.821,p<0.05).3.Urine microalbumin levels[4.6(1.3-9.91)mg/dl]in the high salt group were significantly higher than those in the low salt group and the medium salt group[0.51(0.2-1.18),0.59(0.29-1.73)]mg/dl,respectively.The differences were statistically significant(p=0.000);Multivariate Logistic regression showed that baPWV and 24h urine sodium were risk factors for microalbuminuria(p<0.05).4.The value of baPWV in elderly patients with hypertension increased with the increase of 24h urine sodium,and the baPWV in the high-salt group was significantly higher than that in the low-salt and middle-salt groups.The difference between the groups was statistically significant(p=0.00);The value of 24h urine sodium decreased and the difference between the groups was statistically significant(p=0.00).Multivariate Logistic regression showed that 24h urine sodium and family history of hypertension were risk factors of baPWV abnormalities(p<0.05).Similarly,24h Urine sodium is also a risk factor for abnormal ABI(p<0.05).5.There were 23 patients taking ACEI/ARB drugs alone,57 patients taking CCB drugs alone,and 39 patients taking ACEI+CCB.The mean 24-hour urinary sodium in different groups was(142.5 ± 56.99),(149.07 ± 73.26),(165.5 ± 76.81)mmol/24h and the mean values of urinary potassium at 24h were(42.06 ± 19.13),(46.54±19.31),and(43.01 ± 1].33)mmol/24h,with no significant difference(p>0.05).Conclusions:1.Salt intake is related to early kidney damage and arterial stiffness in elderly hypertensive patients,and its effect is independent of blood pressure;2.Different antihypertensive drugs have an effect on 24h urine sodium excretion;3.For elderly hypertensive patients with high salt intake,it is recommended to use RAAS blockers in combination with diuretics or calcium antagonists.