Sodium-selective salt sensitivity - Its occurrence in blacks
Sodium-selective salt sensitivity - Its occurrence in blacks
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DOI：
10.1161/hypertensionaha.107.091694
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发表时间：
2007-12-01
期刊：
影响因子：
8.3
通讯作者：
Morris, R. Curtis, Jr.
中科院分区：
文献类型：
--
作者：
Schmidlin, Olga;Forman, Alex;Morris, R. Curtis, Jr.
我们验证了膳食NaCl中的Na+成分除了能够补充Cl-的细胞外渗透活性外，还具有升压作用，从而扩大血浆容量的假设。我们研究了35名大多数血压正常的黑人，他们摄入低盐饮食，30 mmol/d，持续3周，在第一和第三周，随机顺序口服NaHCO3或NaCl （250 mmol/d）。在被判定为盐敏感的受试者中（n = 18； δ平均动脉压：>= 5 mm Hg， NaCl负荷），但在耐盐受试者中（n = 17）， NaHCO3负荷也具有升压作用。NaHCO3的降压作用是NaCl的一半：平均动脉压（毫米汞柱）从低NaCl的90显著增加到NaHCO3的95和NaCl的101。NaCl的升压效应与NaHCO3的升压效应有较强的预测关系。通过红细胞压积降低来判断，在耐盐和盐敏感的受试者中，NaCl的血浆体积扩张是NaHCO3的两倍，与升压作用无关。在盐敏感的受试者中，平均动脉压与所有钠（+）负荷下的血浆钠离子浓度直接变化。在盐敏感但不耐盐的受试者中，NaHCO3和NaCl诱导肾血流量减少，肾血管阻力增加；肾血流量变化与两种盐无明显差异。肾血流和肾血管对NaHCO3的反应与对NaCl的反应有很强的相关性。在确立“钠选择性”盐敏感性的事实中，目前的观察表明，NaCl的Na+成分除了在血浆容量扩张中补充Cl（-）的能力外，还具有加压和肾血管收缩的特性。[j] .高血压。2007;50:1085- 1092。
We tested the hypothesis that the Na+ component of dietary NaCl can have a pressor effect apart from its capacity to complement the extracellular osmotic activity of Cl- and, thus, expand plasma volume. We studied 35 mostly normotensive blacks who ingested a low-NaCl diet, 30 mmol/d, for 3 weeks, in the first and third of which Na (+) was loaded orally with either NaHCO3 or NaCl, in random order (250 mmol/ d). In subjects adjudged to be salt sensitive (n = 18; Delta mean arterial pressure: >= 5 mm Hg with NaCl load), but not in salt-resistant subjects (n = 17), loading with NaHCO3 was also pressor. The pressor effect of NaHCO3 was half that of NaCl: mean arterial pressure (millimeters of mercury) increased significantly from 90 on low NaCl to 95 with NaHCO3 and to 101 with NaCl. The pressor effect of NaCl strongly predicted that of NaHCO3. As judged by hematocrit decrease, plasma volume expansion with NaCl was the same in salt-resistant and salt- sensitive subjects and twice that with NaHCO3, irrespective of the pressor effect. In salt- sensitive subjects, mean arterial pressure varied directly with plasma Na+ concentration attained with all Na (+) loading. In salt-sensitive but not salt-resistant subjects, NaHCO3 and NaCl induced decreases in renal blood flow and increases in renal vascular resistance; changes in renal blood flow were not different with the 2 salts. Responses of renal blood flow and renal vascular resistance to NaHCO3 were strongly predicted by those to NaCl. In establishing the fact of " sodium-selective" salt sensitivity, the current observations demonstrate that the Na+ component of NaCl can have pressor and renal vasoconstrictive properties apart from its capacity to complement Cl (-) in plasma volume expansion. (Hypertension. 2007; 50: 1085- 1092.).