| Objective:Hypertension is a key risk factor for stroke,myocardial infarction,heart failure,and kidney failure.A thorough understanding of the pathogenesis of essential hypertension is essential to reduce mortality and morbidity.Salt is an important theme in the pathogenesis of hypertension.However,we still know very little about the factors that influence salt intake on blood pressure,and people in different regions and races have different responses to salt.Therefore,this study will investigate the relationship between salt intake and salt-sensitivity-related genes in patients with essential hypertension in Kunming by investigating the salt intake and salt-sensitivity-related genes in patients with essential hypertension in Kunming.Methods:A total of 507 patients who were diagnosed with essential hypertension in the Hypertension Clinic and Hypertension Ward and treated in Yanan Hospital of Kunming Medical University from May 2018 to January 2020 were selected.Collect 24-hour urine electrolytes from the patients and press 24 The hourly urinary sodium level was used to evaluate the amount of salt intake,and was divided into three groups low salt,medium salt and high salt based on the standard of salt intake.A simple salt questionnaire survey was conducted on the enrolled patients;chewing salt threshold tablets were used for salt threshold determination;oral mucosa specimens of the enrolled patients were collected for genetic testing;at the same time serum samples were collected from patients for blood biochemical and angiotensin A?,vascular tension A?,renin activity;cortisol,aldosterone,adrenocorticotropic hormone detection and 24-hour ambulatory blood pressure monitoring.Results:1.507 hypertensive patients enrolled:(1)A total of 105 patients in the low-salt group(24-hour urine sodium excretion<100 mmol),including 40 males and 65 females,with an average age of 56.89±13.21 years.(2)A total of 260 patients in the medium salt group(24-hour urine sodium excretion of 100-200 mmol),including 124 males and 136 females,with an average age of 55.67±12.03 years.(3)A total of 142 patients in the high-salt group(24-hour urine sodium excretion>200 mmol),including 91 males and 51 females,with an average age of 51.33±12.82 years and an overall average age of(54.71±12.57)years.The proportion of salt intake of the three groups is:low salt group accounts for 21.71%,medium salt group accounts for 51.28%,and high salt group accounts for 28.01%.24h urine sodium level in three groups:low salt group:70.71±19.07mmol,equivalent to sodium chloride 4.24±1.14g/d;medium salt group:147.33±28.93mmol,equivalent to sodium chloride 8.84±1.74g/d;high The salt group is 255.24±53.68mmol,which is equivalent to 15.31±3.22g/d of sodium chloride.The overall 24h urine sodium level was 161.69±74.72 mmol,which was equivalent to 9.70±4.48g/d of sodium chloride.2.The differences in gender,age and body mass index(BMI)of the three groups of patients were statistically significant(P<0.05).Patients with higher salt intake had a greater proportion of men,lower age and greater body mass index;,TC,TG,LDL-C,Na,K,AI(37?),AI(4?),PRA,All,Cortisol,ALD,ACTH were not statistically significant(P>0.05).3.The difference in ambulatory systolic blood pressure and diastolic blood pressure in the three groups was statistically significant(P<0.05).The high-salt group patients' daily systolic blood pressure and diastolic blood pressure were higher than those in the low-salt and medium-salt groups..The difference in 24-hour ambulatory blood pressure between the high-salt group and the low-salt group was statistically significant(P<0.05),and the proportion of "non-dipper" blood pressure in the high-salt group was higher than that in the low-salt group.4.The differences in the scores of the simple salt questionnaire questionnaires among the three groups were statistically significant(P<0.05).The high-salt component value was greater than that of the medium-salt group and the low-salt group;the difference of the salt threshold tablets score was statistically significant(P<0.05)),the value of the high-salt component is greater than that of the medium-salt group and the low-salt group.The correlation between the simple salt questionnaire,salt threshold score and 24h urine sodium was analyzed.The simple salt questionnaire was correlated with 24h urine sodium excretion(r=0.262,P=0.000);the salt threshold score and 24h urine sodium Excretion is correlated(r=0.117,P=0.008).5.The genetic test contains 45 salt-sensitive related sites,involving 32 related genes.Among the three groups,there were statistically significant differences in the distribution of the genotypes and alleles of the SCNN1G genes rs4073930,rs7404408,rs4299163,rs4073291,rs5735,and rs4499238(P<0.05).Compared with individuals with CC or CT genotype,rs7404408 T allele mutation homozygotes had higher 24-hour urine sodium excretion,and the difference was statistically significant(P<0.05);rs4299163 C allele wild homozygote Compared with individuals with GG or CG genotypes,the 24-hour urine sodium excretion was higher,the difference was statistically significant(P<0.05);individuals homozygous for the rs5735 C allele mutation and individuals with TT or TC Compared with individuals with genotypes,their 24-hour urine sodium excretion was higher,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the distribution of other genes(P>0.05).Conclusions1.The salt intake of hypertensive patients in Kunming area far exceeds the standards set by the World Health Organization.2.The SCNN1G gene(site polymorphism)may be associated with 24h urinary sodium excretion in patients with hypertension in Kunming3.The 24-hour ambulatory blood pressure of hypertensive patients with high salt intake in Kunming area suggests that controlling salt intake of hypertensive patients may help control blood pressure levels and improve patient prognosis.4.The salt questionnaire and the determination of salt threshold are not accurate enough to evaluate the amount of salt intake,but it is simple and easy to use,and can also be used as a method of census population salt intake.5.Male hypertensive patients with younger age and larger body mass index in Kunming have higher salt intake. |
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