Comparison Of The Assessment Methods Of Acute Intravenous Saline Loading And Ambulatory Blood Pressure Monitoring On Salt Sensitivity In Essential Hypertension

Objective : In patients with mild and moderate essential hypertension,the acute intravenous saline loading to verify the 24-hour heart rate and blood pressure circadian rhythm of a mbulatory blood pressure monitoring in the simple evaluation of patients with hypertension on salt sensitivit y reliabilit y of risk stratification.Methods : From October,2017 to April,2018,25 cases of mild and moderate essential hypertension hospitaliz ed patients in th e first hospital affiliated to Dalian Medical U niversit y hypertension department were selected.The patients with essential hypert ension were divided into 3 groups according to the 24-hour heart rate and blood pressure circadian rhythm of ambulatory blood pressure monitoring : low risk if dippers and a 24-hour heart rate ? 70 bpm;intermediate risk if dippers with a 24-hour heart rate > 70 bpm or non-dippers with a 24-hour heart rate ? 70 bpm;high risk if non-dippers and a 24-hour heart rate > 70 bpm.Subjects underwent acute intravenous s alt loading: The patients were given a saline load(2 L of 0.9% Na Cl over 4 h,iv),and on the following day,a low-salt diet(20 mmol Na Cl)and furosemide(3 x 40 mg,po).Resting mean arterial pressure was assessed after the saline load and on the morning following salt depletion.When the mean arterial pres sure difference was greater than 10 mm Hg who were salt sensitive hypertension patients,the mean arterial pressure difference was less than 10 mm Hg for non-salt sensitive hypertension patients.In this paper,the salt sensitive hypertension patients ratio of acute intravenous salt l oading was calculated for each s alt-sensitive risk stratification,and the statistical method was compared b y means of the trend chi-square test,and P < 0.05 was considered statisticall y s ignificant.Results :1.Through the salt sensitivit y risk assessment method of the 24-hour heart rate and blood pressure circadian rhyt hm of a mbulatory blood pressure m onitoring i n 25 patients with essential hypertension,salt sensitive low risk group 5 cases(20.00%),intermedi ate risk group of 13 cases(52.00%),high risk group of 7 cases(28.00%).2.Salt sensitivit y ass essment was carried out in 25 patients with essential hypertension with acute intravenous saline loading,and 11 cases of salt sensitive hypertension patients were confirmed,accounting for 44.00% and 14 cases of non-salt sensitive hypertension patients,accounting for 56.00%.3.The assessment method of ambulatory bl ood pressure monitoring for salt sensitivit y risk stratification in patients with essential hypertension,compared with the evaluation method of acute intravenous saline loading,the salt sensitive low risk group b y acute intravenous saline loading confirmed the proportion of patients with salt sensitive hypertension was 20%(1/5),intermediate risk group in patients with salt sensitive hypertension was 38.46%(5/13),salt sensitive hypertension in a high-risk group of patients was 71.43%(5/7).Increas ed with salt sensitive risk stratification,the proportion of patients with acute intraven ous saline loading in the diagnosis of the patients with salt sensitive hypertension has increasing trend,the trend chi-square anal ysis P = 0.089,0.05 inspection level showed no statistical significance.4.To acute intravenous saline loading eval uation method validation of essential hypertension patients were divided into salt sensitive hypertension group and the non-salt sensitive hypertension group.The nighttime s ystolic blood pressure of salt sensitive hypertension group more than non-salt sensitive hypertension group obviousl y hi gher [(142.09 ± 12.68)mm Hg ratio(128.86 ± 13.97)mm Hg,P < 0.05];The nighttime diastolic blood pressure of the salt sensitive hypertension group was higher than that of the non-salt sensitive hypertension group,but it did not reach the statistical difference [(87.91 ± 10.78)mm Hg ratio(80.64 ± 13.83)mm Hg,P > 0.05].Conclusion: With the 24-hour heart rate and blood pressure circadian rhythm of ambulatory blood pressure monitoring in the simple evaluation of patients with hypertension on salt sensitivit y,can evaluate the salt sensitivit y of patie nts with essential hypert ension,simple,is good for hypertension patients in clinical individualized treatment strategy formulation.