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Association Between Blood Pressure Responses to the Cold Pressor Test and Dietary Sodium Intervention in a Chinese Population
Jing Chen, MD, MSc;
Dongfeng Gu, MD, MSc;
Cashell E. Jaquish, PhD;
Chung-Shiuan Chen, MS;
D. C. Rao, PhD;
Depei Liu, PhD;
James E. Hixson, PhD;
L. Lee Hamm, MD;
C. Charles Gu, PhD;
Paul K. Whelton, MD, MSc;
Jiang He, MD, PhD; for the GenSalt Collaborative Research Group
Arch Intern Med. 2008;168(16):1740-1746.
Background Blood pressure (BP) responses to the cold pressor test (CPT) and to dietary sodium intake might be related to the risk of hypertension. We examined the association between BP responses to the CPT and to dietary sodium and potassium interventions.
Methods The CPT and dietary intervention were conducted among 1906 study participants in rural China. The dietary intervention included three 7-day periods of low sodium intake (3 g/d of salt [sodium chloride] [51.3 mmol/d of sodium]), high sodium intake (18 g/d of salt [307.8 mmol/d of sodium]), and high sodium intake plus potassium chloride supplementation (60 mmol/d). A total of 9 BP measurements were obtained during the 3-day baseline observation and the last 3 days of each intervention using a random-zero sphygmomanometer.
Results Blood pressure response to the CPT was significantly associated with BP changes during the sodium and potassium interventions (all P < .001). Compared with the lowest quartile of BP response to the CPT (quartile 1), systolic BP changes (95% confidence intervals) for the quartiles 2, 3, and 4 were –2.02 (–2.87 to –1.16) mm Hg, –3.17 (–4.05 to –2.28) mm Hg, and –5.98 (–6.89 to –5.08) mm Hg, respectively, during the low-sodium intervention. Corresponding systolic BP changes during the high-sodium intervention were 0.40 (–0.36 to 1.16) mm Hg, 0.44 (–0.35 to 1.22) mm Hg, and 2.30 (1.50 to 3.10) mm Hg, respectively, and during the high-sodium plus potassium supplementation intervention were –0.26 (–0.99 to 0.46) mm Hg, –0.95 (–1.70 to –0.20) mm Hg, and –1.59 (–2.36 to –0.83) mm Hg, respectively.
Conclusions These results indicate that BP response to the CPT was associated with salt sensitivity and potassium sensitivity. Furthermore, a low-sodium or high-potassium diet might be more effective to lower BP among individuals with high responses to the CPT.
Author Affiliations: Department of Medicine, Tulane University School of Medicine (Drs J. Chen, Hamm, and He), and Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (Drs J. Chen and He and Ms C.-S. Chen), New Orleans, Louisiana; Fuwai Hospital and Cardiovascular Institute (Dr D. Gu) and Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences (Dr Liu), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Chinese National Center for Cardiovascular Disease Control and Research, Beijing (Dr D. Gu); Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland (Dr Jaquish); Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri (Drs Rao and C. C. Gu); Department of Epidemiology, University of Texas School of Public Health, Houston (Dr Hixson); and Office of the President, Loyola University Medical Center, Maywood, Illinois (Dr Whelton).
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