Association between salt sensitivity of blood pressure and the risk of hypertension in a Chinese Tibetan population

Abstract

Epidemiological studies have confirmed salt sensitivity as a crucial risk factor for the development of hypertension. However, few studies have investigated the association between salt sensitivity of blood pressure (SSBP) and hypertension in Chinese Tibetan population. Therefore, we conducted a cross‐sectional study based on a Tibetan population to evaluate the association between SSBP and the risk of hypertension. Seven hundred and eighty‐four participants with hypertension and 645 participants without hypertension were included from five villages in Tibetan Autonomous Region of Gannan during 2013–2014. The assessment of salt sensitivity (SS) and non‐salt sensitivity (NSS) was performed according to mean arterial pressure (MAP) changes by the modified Sullivan's acute oral saline load and diuresis shrinkage test (MSAOSL‐DST). Logistic regression models and restricted cubic models were used to examine the association between SSBP and hypertension. There were 554 (70.5%) salt‐sensitive participants with hypertension and 412 (63.9%) salt‐sensitive participants without hypertension in this study. Compared with individuals with NSS, individuals with SS had a significantly increased risk of hypertension, and the multiple‐adjusted odds ratios were 2.582 with 95% confidence interval of 1.357–4.912. Furthermore, a significant linear trend was found between MAP changes and hypertension. Subgroup analyses showed significant and stronger associations between SSBP and the risk of hypertension in the older (age ≥ 55 years old), males and participants who took exercise less than 1 time per week. Our results suggest that SS is associated with an increased risk of hypertension in Tibetan population, indicating a need for clinicians dealing with SSBP to decrease the risk of hypertension.

Risk factors and a predictive model for left ventricular hypertrophy in young adults with salt‐sensitive hypertension

“…The 580 patients with salt-sensitive hypertension were evaluated by the modified acute saline loading method. 16,17 Blood pressure parameters of each patient were measured during the first 24 h after admission. Office blood pressure was measured using a validated semiautomatic device (Omron HEM-1020, Omron Healthcare, Kyoto, Japan) on the same arm while the participant was in a seated position.…”

“…16 The assessment of salt sensitivity was conducted using a modified acute saline loading method (Figure S2) known as modified Sullivan's method after CPT assessment. 16,17 Blood pressure was measured three times at 8:00 a.m., and the average value was considered the baseline blood pressure for each fasting patient. Subsequently, a 4-h intravenous infusion of 2000 mL of 0.9% saline was administered, and 40 mg of furosemide was given orally immediately after the saline infusion.…”

“…An increase in the MAP of more than 5 mm Hg after acute salt loading and/or a decrease in the MAP of more than 10 mm Hg after the diuresis shrinkage test were considered to indicate salt-sensitive. 16,17…”