Effect of Salt Substitution on Cardiac Structure and ECG Parameters in Middle-aged and Elderly Hypertensive Patients.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2024-10-31 eCollection Date: 2024-11-01 DOI:10.31083/j.rcm2511390
Li Che, Ying Zhang, Xia Chen, Haiqing Du, Wei Song, Yinong Jiang
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引用次数: 0

Abstract

Background: Salt substitution (SS) has been found to reduce blood pressure (BP). However, the impact of SS on cardiac structure, as assessed through ultrasonic cardiogram (UCG) and electrocardiograms (ECG), remains poorly understood. This study aims to evaluate the effects of SS on cardiac structure and ECG parameters.

Methods: This 12-month prospective, multi-center, randomized, double-blind study involved hypertensive patients aged 50 to 70 years with office systolic BP (SBP) ranging from 140 to 180 mmHg and diastolic BP (DBP) ranging from 90 to 110 mmHg. A total of 352 patients were enrolled and equally randomized to either the normal salt (NS) group or SS group. Office BP measurements (OBPM) were obtained at baseline and at 3, 6, and 12 months, while home BP measurements (HBPM) were recorded at baseline, 3, 6, 9, and 12 months. Fasting blood, UCG, and ECG parameters were obtained at baseline and at the end of the study.

Results: Of the 352 enrolled patients, 322 completed the study. In the SS group, the reductions in systolic OBPM, HBPM, and diastolic HBPM were significantly greater than those in the NS group. Notable cardiac parameter changes included a reduction in QT dispersion (QTd) by -5 ms (-10, 5) in the NS group and -5 ms (-15, 0) in the SS group (p = 0.001); the T wave peak-to-end (Tp-e) value was 0 ms (-5, 10) and -5 ms (-10, 0) (p < 0.001), respectively; and Tp-e/QT was 0 (-0.01, 0.02) and -0.02 (-0.04, 0) (p < 0.001), respectively. Additionally, left atrial diameter (LAD) was 0 mm (-1, 1) and -1 mm (-2, 1) (p < 0.001), and the change in left ventricular mass (LVM) was -2 g (-17.75, 11) and -7 g (-18, 6) (p = 0.035), respectively.

Conclusions: This study demonstrates that SS not only significantly decreased LAD and LVM, indicating a significant effect on cardiac structure, but also improves UCG parameters, including reductions in QTd, Tp-e, and Tp-e/QT. These findings highlight the potential of SS as a beneficial intervention in managing cardiac risks in hypertensive patients.

Clinical trial registration: ChiCTR1800019727. (https://www.chictr.org.cn/showproj.html?proj=31036).

盐替代对中老年高血压患者心脏结构及心电图参数的影响。
背景:食盐替代(SS)已被发现可以降低血压(BP)。然而,通过超声心动图(UCG)和心电图(ECG)评估的SS对心脏结构的影响仍然知之甚少。本研究旨在探讨SS对心脏结构及心电图参数的影响。方法:这项为期12个月的前瞻性、多中心、随机、双盲研究纳入了年龄在50至70岁、有效收缩压(SBP)在140至180 mmHg之间、舒张压(DBP)在90至110 mmHg之间的高血压患者。共有352例患者入组,随机分为正常盐(NS)组和正常盐(SS)组。在基线、3、6和12个月时获得办公室血压测量(OBPM),而在基线、3、6、9和12个月时记录家庭血压测量(HBPM)。在基线和研究结束时获得空腹血、UCG和ECG参数。结果:352例入组患者中,322例完成了研究。在SS组中,收缩期OBPM、HBPM和舒张期HBPM的降低明显大于NS组。显著的心脏参数变化包括:NS组QT离散度(QTd)减少-5 ms (- 10,5), SS组QT离散度(QTd)减少-5 ms (- 15,0) (p = 0.001);T波峰端(Tp-e)值分别为0 ms(- 5,10)和-5 ms (- 10,0) (p < 0.001);Tp-e/QT分别为0(-0.01,0.02)和-0.02 (-0.04,0)(p < 0.001)。左房内径(LAD)分别为0 mm(- 1,1)和-1 mm (- 2,1) (p < 0.001),左室质量(LVM)变化分别为-2 g(-17.75, 11)和-7 g (- 18.6) (p = 0.035)。结论:本研究表明,SS不仅能显著降低LAD和LVM,对心脏结构有显著影响,还能改善UCG参数,包括降低QTd、Tp-e和Tp-e/QT。这些发现强调了SS作为高血压患者心脏风险管理有益干预的潜力。临床试验注册:ChiCTR1800019727。(https://www.chictr.org.cn/showproj.html?proj=31036)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
期刊介绍: RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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