尿中のナトリウム排出量,血圧,心血管疾患,死亡率:地域レベルでの前向きな疫学コホート研究
Andrew Mente1, Martin O'Donnell2, Sumathy Rangarajan3
1Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, McMaster University, Hamilton, ON, Canada.
Lancet (London, England)
|August 22, 2018
まとめ
高いナトリウム摂取量を減らすことで,特に1日5g以上を摂取するコミュニティでは,心血管疾患を予防することができます. これらの集団でナトリウムを減らすことは 効果的な公衆衛生戦略であり 心血管の健康に役立ちます
科学分野:
- 心臓病科
- 公衆衛生
- 流行病学
背景:
- 世界保健機関 (WHO) は,心臓血管疾患 (CVD) を予防するために1日当たり2g未満のナトリウム摂取を推奨しています.
- この推薦は血圧データに基づいているが,心血管疾患に関するランダム化試験の証拠は得られていない.
- 以前の研究は,低ナトリウム摂取と心血管疾患の減少との明確な関連を確立していなかった.
研究 の 目的:
- コミュニティレベルでの平均ナトリウムとカリウム摂取量と心血管疾患 (CVD) と死亡率との関連を調査する.
- 食中のナトリウムとカリウムと血圧 (BP) の関係を地域レベルで調べる.
- 世界的なナトリウム摂取の推奨値の改定のための証拠を提供すること.
主な方法:
- 18か国における将来的な都市農村疫学 (PURE) 研究からのデータの分析.
- 前例のCVDのない35~70歳の95,767人の成人を含む.
- 摂取量を評価するために,朝の空腹の尿サンプルを用いて24時間のナトリウムとカリウムの排泄量を推定する.
- ナトリウム/カリウムの摂取と高血圧,CVD,および死亡率との間のコミュニティレベルでの関連性の評価,個別レベルの混同調整.
主要な成果:
- 平均シストリック血圧 (BP) は,ナトリウム摂取量が増加すると,特に摂取量の第三位数 (> 5. 08g/日) が最も多い地域において増加した.
- 心血管疾患はナトリウム摂取と非線形に関連しており,最も低い三位数 (<4. 43g/ 日) で有意な逆相関があり,中間三位数 (4. 43- 5. 08g/ 日) で相関はありません.
- カリウム摂取量の増加は,すべての国で心血管疾患の減少と関連していました. 中国では脳卒中の発生率は 高いナトリウム摂取量と強く関連しています
結論:
- ナトリウム摂取は心臓血管疾患と脳卒中と関連しており,主に平均摂取量が1日5gを超える地域において発生しています.
- 高い摂取量を持つ地域において ターゲットに絞ったナトリウム削減戦略は 普遍的な勧告より 適切かもしれない.
- ダイエット中のカリウム摂取量を増やすことは,世界的に心臓血管の健康に有益であるようです.
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