| Aims:Through two pre-tests,in the community of hypertensive and diabetic people who are taking antihypertensive drugs and hypoglycemic drugs regularly: 1.Preliminary exploration of the effects of 18%sodium-restricted formula salts on blood pressure reduction,sodium reduction,and potassium intake increase.And the patient’s willingness to accept;2.A preliminary study on the effect of Chinese-style Deshu diet in community hypertension and diabetes,providing basic data for the next randomized controlled trial,and providing a scientific basis for the management of lifestyle of hypertension and diabetes patients.Methods:The pre-tests were designed with their own before and after control tests.(1)Trial 1: Patients with hypertension in the community under the jurisdiction of Nanan District People’s Hospital of Chongqing City will be included in the baseline survey.A baseline survey will be conducted.Patients will use 18% sodium-restricted salt to replace other edible salt for8 weeks.Follow-up visits were conducted once a week at home to collect information such as blood pressure and the use of sodium-restrictedformulae in the family.The patients were collected for 24 hours before and after the intervention,and their sodium and potassium were measured.Individual qualitative interviews were conducted with all patients at the later stage of the intervention to understand the situation.The taste of the formulated salt and the patient’s willingness to accept it.(2)Trial 2: Patients with primary hypertension,hypertension with type 2diabetes,and patients with simple type 2 diabetes who meet the inclusion criteria within the jurisdiction of Tiansheng Community Health Service Center in Beibei District,Chongqing.After completing the baseline survey,the subjects were given a Chinese-style Deshu diet for two weeks.During the intervention,all patients drank intensively in the designated cafeteria(morning,middle,and evening).Patients were followed up every 2 to 3days to collect information on blood pressure,blood sugar,blood pressure,use of hypoglycemic drugs,and adverse events.(3)Epidata 3.1 and SPSS22.0 software were used to organize and analyze the data;paired t test was used to compare the changes in blood pressure and blood glucose before and after the intervention,and McNemar test was used to compare the blood pressure compliance rate before and after the intervention.<0.05 indicates that the difference is statistically significant.Results:Test one:(1)A total of 43 subjects were included,4 were lost to follow-up,and 39 patients participated in the whole trial,including 20 males and 19 females;aged(67.05 ± 7.86)years old.After 8 weeks of intervention with 18%sodium limited salt,the systolic blood pressure decreased from baseline(135.08 ± 16.84)to(123.71 ± 9.87)mm Hg at the eighth week.The difference was statistically significant(P <0.001).72.63±8.17)decreased to(69.14 ± 8.31)mm Hg,the difference was statistically significant(P<0.05);systolic blood pressure decreased significantly during the first week of intervention(-9.90 mm Hg,95% CI:-15.62 ~-4.18,P <0.001),the diastolic blood pressure decreased significantly in the second week of intervention(-3.82 mm Hg,95% CI:-7.05 to-0.60,P <0.05),and then gradually stabilized.(2)After 8 weeks of intervention with 18% sodium-limited formula salt,the patient’s urine sodium decreased from 151.9±56.0mmol / 24 h to 138.1± 57.1mmol / 24 h at baseline,the difference was not statistically significant(t = 1.246,(P> 0.05);Urine potassium increased from 52.2±19.3mmol / 24 h to 61.0±17.3mmol / 24 h at baseline,the difference was statistically significant(t =-2.411,P <0.05);sodium / potassium decreased by 0.9 units,and the difference was statistically significant Significance(T=-3.265,P <0.001).(3)Through qualitative interviews with patients,the results show that87.2% of patients think that the salt has astringent or aromatic taste,and thevast majority(84.6%)of patients indicate that they can accept the taste of the salt after adapting for a period of time;59.0% of patients Expressed willingness to consume this formula salt for a long time,the main reason is that it has a good antihypertensive effect;17.9% of patients said that they may be unwilling to consume it for a long time because of the bad taste of the salt;and 23.1% of patients remained neutral despite receiving the taste.Test two:(1)61 eligible subjects were included,8 were lost to follow-up,and 53 persons completed the full test.Among them,there were 17 patients with simple hypertension,23 with hypertension and diabetes,and 13 with simple diabetes.The majority of patients in the three groups were retired patients,aged 68.3±6.8,68.7±4.5,and 64.0±3.6 years.(2)Control of blood pressure and blood glucose of patients before and after the intervention test: The systolic blood pressure and diastolic blood pressure of patients in the simple hypertension group decreased from 143.6±10.9 and 78.8±11.1mm Hg to 130.1±10.1 and 75.6±8.3mm Hg at baseline,respectively.The difference in systolic blood pressure was statistically significant(p <0.05);the systolic and diastolic blood pressure in patients with hypertension and diabetes decreased from 145.8±23.4 and73.6 ± 6.5mm Hg at baseline to 119.3 ± 19.6 and 66.5 ± 9.2mm Hg respectively.The differences were statistically significant(both p <0.05),and the systolic blood pressure of patients in the hypertension group andthe hypertension combined with diabetes group gradually decreased with the extension of the intervention time;the systolic and diastolic blood pressure in the diabetic group were also different.It decreased by 13.5 and5.7mm Hg,and the differences were not statistically significant(both p>0.05).Although the differences in fasting blood glucose values before and after intervention in the hypertension-complicated diabetes group and the diabetes group were not statistically significant,the 2h postprandial blood glucose decreased from 16.1±6.9,16.4±2.9(mmol / L)at baseline to 8.2 ± 3.6,12.6 ± 8.8(mmol / L),the differences were statistically significant(all p <0.05).(3)The use of antihypertensive and hypoglycemic drugs before and after the intervention trial: A total of 15 patients adjusted their antihypertensive drugs,of which 7 were reduced,8 were discontinued,the reduction rate was 13.2%,and the discontinuation rate was 15.1%.In patients,drug reduction / withdrawal occurred mostly in the middle and late stages of the intervention.Conclusion:(1)The application of 18% sodium-restricted formula salt is feasible in the community with hypertension,and it has been initially shown that it has a hypotensive effect and can reduce the patient’s urine Na / K.The patient feels that his taste needs further improvement;(2)After 2 weeks of improved salt-limiting Chinese Deshu dietintervention,it can effectively reduce blood pressure and blood sugar of patients with essential hypertension and / or diabetes,reduce the use of antihypertensive and hypoglycemic drugs in some patients,and improve management Compliance. |
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