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고령 고혈압 환자에서 천일염의 혈압 감소 효과: 예비 무작위 대조시험

Anti-Hypertensive Effect of a Solar Salt Diet in Elderly Hypertensive Patients: A Preliminary Randomized, Double-Blind Clinical Trial

이혜리|조수현|김정하|백승하|안주원
대한임상건강증진학회 (Korean Society For Health Promotion And Disease Prevention)|2015.09|Korean Journal of Health Promotion|제15권 제3호|pp. 98-107|DOI http://dx.doi.org/10.15384/kjhp.2015.15.3.98

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참고문헌

키워드

혈압고혈압HypertensionAged고령천일염SaltBlood pressureRandomized controlled trial무작위 대조 시험
주제분류기타자연과학

초록

연구배경: 나트륨 과다 섭취와 적은 미네랄 섭취는 혈압상승과 연관된 것으로 알려져 있으며, 정제 소금을 저염도, 고미네랄 천일염으로 대체하는 것은 혈압을 낮춘다고 보고되고 있다. 천일염은 한국에서 건강한 식습관을 위한 저염도, 고미네랄 소금으로 부상되고 있다. 따라서 정제 소금을 천일염으로 대체한 고령 고혈압 환자의 혈압 변화에 대하여 연구하기 위하여 무작위 이중 맹검 위약 대조시험을시행하였다. 방법: 43명의 65세 이상 노령 고혈압 환자가 이 실험에최초 등록되었고, 이 중 38명(88.4%)이 시험을 완료했다. 연구 대상은 실험군으로 천일염 그리고 대조군으로 정제염을섭취하는 식생활을 8주 동안 진행하였다. 결과: 천일염을 섭취하는 집단은 정제염을 섭취하는 대조집단과 비교하였을 때 수축기 혈압이 2, 4, 8주 후에 크게감소하였고, 확장기 혈압 또한 8주 후에 크게 떨어졌다. 또한 천일염을 섭취하는 집단에서는 소변 중 나트륨/칼륨과ACE 활동이 정제염을 섭취하는 집단보다 크게 감소하였다. 소변 중 칼륨 배설 또한 크게 증가하였다. 결론: 이러한 결과는 고령 환자에서 천일염이 혈압에 유익한 효과가 있다는 임상 증거를 제공하고 있으며, 한국인과 같이 충분한 미네랄 섭취가 부족한 경우에 천일염을 사용하여 더 큰 항고혈압 효과를 가질 수도 있을 것으로 보인다. 따라서 추가적인 대규모 연구가 요구된다.

Abstract

Background: High sodium and/or low mineral intake are known to be associated with elevated blood pressure. It has been reported that substituting low-sodium, mineral-rich salt for refined salt lowers blood pressure (BP). And solar salt is emerging as a low sodium high mineral salt for a healthy diet in Korea. Therefore, this double- blind, randomized, and placebo-controlled trial was conducted to explore changes in BP from substituting refined salt with solar salt among hypertensive elderly subjects. Methods: Forty-three hypertensive and institutionalized elderly individuals aged 65 years or older were enrolled. Thirty-eight subjects (88.4%) completed the study. Subjects were provided with either a solar salt- or refined salt-based diet for eight weeks. Results: Systolic BP decreased significantly in the solar salt-based diet group after 2, 4, and 8 weeks when compared to the refined salt-based diet group. And, diastolic BP was lowered significantly in the solar salt-based diet group compared to that in the refined salt-based diet group after 8 weeks. In addition, urinary sodium/potassium, and angiotension converting enzyme activity decreased significantly in the solar salt-based diet group compared to the refined salt-based group. Urinary potassium excretion was significantly increased in the solar salt-based diet group. Conclusions: These results may provide clinical evidence that solar salt has beneficial effects on BP in elderly patients. And, people such as Koreans, who do not consume enough minerals, may experience a greater anti- hypotensive effect by using solar salt. However, further large-scale studies are necessary.

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