| Background:The prevalence rate of hypertension in adults aged 18 years and above in China is about 25.2%,and the prevalence rate of hypertension in the 64-74 year old population is about 48.8%.A large number of studies have confirmed that excessive sodium intake is an important environmental factors to the occurrence and development of primary hypertension,and elderly hypertensive patients as a special type of hypertension,their salt sensitivity was higher than that of the youth and middle-aged hypertensive population,and the risk of Diabetes,coronary heart disease and stroke is also much higher than normal blood pressure population,Therefore,more attention had paid to the research and prevention of the elderly hypertensive patients.By reducing salt intake and high potassium supplementation can significantly reduce blood pressure in elderly hypertensive patients.However,uncertainties still exist about the existence and the amount of such an effect,and about the role of some potential effect-modifiers,including the baseline potassium intake and geographical area.Objective:To observe ambulatory blood pressure variation in hypertensive patients before and after the low salt diet and low sodium salt diet(rich in potassium chloride),and to analysis the effects of low salt and low sodium salt in hypertensive patients with different ages.Methods:84 primary hypertensive patients admitted to the First Affiliated Hospital of Dalian Medical University from April 2016 to December 2016 were enrolled in this study,18-75 years old.In this study,patients were diagnosed hypertension according to "the 2010 Chinese Hypertension Guideline",collect the medical history and related biochemical tests.The 84 patients will be divided into the elderly group(60-75 years old)and non elderly group(18-60 years old).The ambulatory blood pressure monitoring system was used in the study to monitor the 84 patients,Analyzing the 24 hours,daytime and night blood pressure,and the pulse pressure.Then the above two groups were given the general food(salt 12g/day),low salt diet(salt 6g/day),and the low sodium salt diet(salt 4.5g/day,potassium chloride 2.7g/day)respectively.Dietary intervention for 1 weeks,and the patient was given unified meal by The Nutrition Department of hospital.At the end of 7th day,we use urine sodium investigation to assess the effects of the diets,and the ambulatory blood pressure monitoring was conducted again to observe the changes of blood pressure before and after diet intervention.The SPSS 20.0 statistical package and EXCEL 2009 are applied for statistical processing and analyzing;the continuous variables are demonstrated in form of "mean±standard deviation";paired t test are applied to compare the result before and after the intervention over diet,chi-square was applied to the classification variables;P<0.05 is regarded as statistical significant.Results:1)The comparison of basic date between the two groups did not show the statistical significance(P>0.05)[gender,body mass index(BMI),fasting blood glucose(FBG),uric acid(UA),creatinine,TG,TC,HDL-C,LDL-C],the Comparison of medication between two groups did not show the statistical significance(P>0.05)[CCB,ACEI/ARB,BB,AB,diuretic].The statistical significance did not show in the different diet groups of elderly hypertensive patients(P>0.05).2)The comparison of urinary sodium of non elderly hypertensive patients with Potassium supplementation salt group,Elderly hypertensive patients with low salt group,Elderly hypertensive patients with Potassium supplementation salt group is decreased after intervention(P=0.02,0.03,0.01 respectively).3)the comparison of ABPM among Elderly hypertensive patients before and after dietary intervention:the 24h systolic blood pressure,nocturnal systolic blood pressure,daytime diastolic blood pressure,nocturnal pulse pressure in the low salt diet decreased obviously,there was statistical sidnificant in the groups(P = 0.04,0.03,0.03,0.01).The 24h systolic blood pressure,daytime systolic blood pressure,nocturnal systolic blood pressure,nocturnal diastolic blood pressure,24h pulse pressure,nocturnal pulse pressure in the low sodium salt diet decreased obviously,there was statistical sidnificant in the groups(P=0.01,0.03,0.01,0.04,0.02,0.02).4)The comparison of blood pressure in different diet groups in Elderly hypertensive patients before and after dietary intervention:the 24h systolic blood pressure,nocturnal systolic blood pressure,nocturnal pulse pressure is decreased significantly,and the statistical significance was show compared with the common diet group(P=0.02,0.03,0.03);and the statistical significance was show in the 24h systolic blood pressure,nocturnal systolic blood pressure,nocturnal pulse pressure with low sodium salt group(P=0.03,0.01,0.01);there was no statistical significance between the low salt group and low sodium salt group(P>0.05).5)The comparison of blood pressure before and after dietary intervention between non elderly hypertensive patients and elderly hypertensive patients:the statistical significance was showed in the 24h diastolic blood pressure,daytime diastolic blood pressure of low salt group(P=0.03,0.02);and the statistical significance was showed in the nocturnal systolic blood pressure,nocturnal diastolic blood pressure and nocturnal pulse pressure of low sodium salt group(P=0.02,0.04,0.03 respectively).Conclusion:1.Low salt and potassium supplementation salt diet can effectively reduce blood pressure in hypertensive patients,especially the elderly hypertensive patients;2.To evaluate the level of sodium and potassium intake in patients with urinary sodium and urinary potassium,to detection the blood pressure with ABPM monitoring,drafting the corresponding salt restriction and potassium supplementation project can effectively reduce blood pressure in elderly hypertensive patients,and can also improve the quality of life in elderly hypertensive patients and reduce clinical complications;3.Elderly hypertensive patients with low salt and potassium supplementation is better than non elderly hypertensive patients. |
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