| Objective:To investigate the baseline urinary sodium and potassium excretion in patients with essential hypertension in Shanxi Province,and to explore the correlation between urinary sodium and potassium excretion and blood pressure,as well as gender differences,in order to provide new clinical evidence for blood pressure control and dietary management in patients with hypertension.Methods:A total of 606 hospitalized patients with essential hypertension aged between 18 and80 years old who met the inclusion criteria were selected from 16 hospitals with regional representative and experimental conditions in Shanxi Province from June 2018 to December 2020.The basic information,medication history,serum biochemical indicators,and 24 h ambulatory blood pressure monitoring data of the patients were collected.The patients were divided into three groups according to 24 h urinary sodium excretion: low urinary sodium group(n=33): urinary sodium ≤ 100mmol/24 h,moderate urinary sodium group(n=394): 100 mmol/24 h < urinary sodium ≤200 mmol/24 h,high urinary sodium group(n=179): urinary sodium >200 mmol/24 h.The patients were divided into male group(n=368)and female group(n=238)according to gender.Spearman correlation analysis was used to explore the relationship between 24 h urinary sodium,potassium excretion and sodium to potassium ratio and blood pressure in the selected population and gender subgroups.Multivariate linear regression analysis was used to analyze the relationship between 24 h urinary sodium,potassium excretion and blood pressure in different genders.Results:1.A total of 606 subjects were enrolled in this study.The median 24 h urinary sodium excretion was 171.14(139.65-207.75)mmol,the median 24 h urinary potassium excretion was 39.98(29.30-54.47)mmol,and the median 24 h urinary sodium to potassium ratio was 4.28(3.07-5.96).Compared with the medium and high urinary sodium excretion groups,the 24 h urinary sodium and potassium excretion,urinary sodium to potassium ratio,24 h ambulatory blood pressure parameters(24h SBP,24 h DBP,d SBP,d DBP,n SBP,n DBP)in the low urinary sodium excretion group were significantly lower(P<0.05).n SBP was significantly higher in the high urinary sodium excretion group than in the medium urinary sodium excretion group(P<0.05).There were no significant differences in age,body mass index(BMI),history of diabetes,and history of hyperlipidemia among the three groups(P > 0.05).Spearman correlation analysis showed that 24 h urinary sodium excretion was significantly positively correlated with 24 h SBP,24 h DBP,d SBP,d DBP,n SBP and n DBP in patients with essential hypertension in Shanxi Province(P<0.001).24 h urinary potassium excretion was significantly negatively correlated with 24 h SBP,d SBP,and n SBP(P<0.05),and urinary sodium to potassium ratio was significantly positively correlated with 24 h SBP,d SBP,and n SBP(P<0.001).2.The 24 h urinary sodium excretion of the male group [176.57(144.00～215.95)mmol] was higher than that of the female group [164.00(129.75～198.50)mmol](P<0.001).There was no significant difference in 24 h urinary potassium excretion between male group [39.93(30.97～52.98)mmol] and female group [40.16(27.81～55.46)mmol](P=0.708).The sodium-potassium ratio in male group [4.37(3.24～6.23)] was significantly higher than that in female group [4.21(2.79～5.59)](P=0.041).Compared with the female group,the male group had a younger average age and a higher BMI,and there was no significant difference between the history of diabetes and hyperlipidemia.Spearman correlation analysis showed that 24 h urinary sodium excretion was significantly positively correlated with 24 h SBP and n SBP in the male group(P < 0.05),and 24 h urinary potassium excretion was significantly negatively correlated with 24 h SBP and n SBP(P < 0.05).Urinary sodium to potassium ratio was positively correlated with24 h SBP,d SBP and n SBP(P < 0.05).In female group,24 h urinary sodium excretion was positively correlated with 24 h SBP,24 h DBP,d SBP,d DBP,n SBP and n DBP(P< 0.05),and 24 h urinary potassium excretion was negatively correlated with n SBP(P< 0.05).Urinary sodium to potassium ratio was positively correlated with 24 h SBP,d SBP and n SBP(P < 0.001).Multiple linear regression showed that 24 h urinary sodium excretion was positively correlated with 24 h SBP and n SBP in the male group(P< 0.05),and24 h SBP,24 h DBP,d SBP,d DBP,n SBP and n DBP in the female group(P< 0.001)after adjusting for important confounding factors.24 h urinary potassium excretion was negatively correlated with 24 h SBP,d SBP and n SBP in both male and female groups(P <0.05).Conclusion:The characteristics of high urinary sodium excretion,low urinary potassium excretion,and high urinary sodium to potassium ratio are closely related to elevated blood pressure in patients with essential hypertension in Shanxi Province,and there are significant gender differences,and they are more positively correlated with blood pressure in women.Gender differences should be considered in the prevention,treatment,and dietary intervention of hypertension. |
