An investigation of the reductive effect of blood pressure and increment of urinary sodium excretion with calcium and potassium supplementation in children with sodium sensitivity is conducted. In total of 261 school children who had completed a 2-year double-blinded, placebo-controlled trial with calcium and potassium supplementation salt sensitivity, with a salt volume expansion and contraction protocol, was determined. The results showed that in children with salt sensitivity, the increase in blood pressure in the supplementary group was lower by 4.3/4.8 mmHg than that in the placebo group (P<0.05), while no significant change was found between the supplementary group and placebo group in children with nonsalt sensitivity. With calcium and potassium supplementation, the night urinary sodium excretion in children with salt sensitivity was significantly increased (P<0.01), and it is negatively correlated with the increase in blood pressure. It was suggested that a moderate increase of calcium and potassium intake in children with salt sensitivity, through interaction with sodium, can promote urinary sodium excretion and may play contribute to the prevention of hypertension.
Sodium-lithium countertransport (Na-Li CT) is associated with blood pressure (BP) and in many cross-sectional investigations and some longitudinal studies, essential hypertension has been proposed as a biochemical marker or predictor of hypertension risk in adults. The present study investigated prospectively whether baseline Na-Li CT rate was an index of increased risk of future development of hypertension in children. At baseline visit in 1987 of the Hanzhong Children Hypertension Study comprising 4000 school children aged 5-6 years old, 310 samples were randomly selected for measurement of baseline Na-Li CT rate; we made a 10-year follow-up of them in the same season in 1997. This cohort of children is the sample for analysis in the present report. Baseline Na-Li CT rate was positively correlated to systolic BP (SBP) both in baseline and follow-up (baseline, gamma=0.21, P<0.05; follow-up, gamma=0.32, P<0.01), and positively correlated to diastolic BP (DBP) (gamma=0.20, P<0.05) and body mass index (gamma=0.18, P<0.05) in follow-up examination. Longitudinal analysis of 10-year BP evolution, children in higher baseline Na-Li CT (ie, >260 micromoll RBC/h) had greater BP change than children in lower baseline Na-Li CT (ie, =260 mumol/l RBC/h) (SBP, 15.8+/-12.9 vs 19.3+/-13.1, DBP 8.8+/-11.2 and 11.3+/-10.6, P<0.05). Multiple logistic regression analysis showed that children in the higher Na-Li CT (>260 mumol/l RBC/h) were associated with approximately 1.5 times greater risk of high BP) in comparison to placement in lower Na-Li CT (=260 mumol/l RBC/h). Elevated baeline RBC Na-Li countertransport could be a risk predictor predisposing to the development of hypertension in children.
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