Heterogeneous responses to changes in dietary salt intake: The salt-sensitivity paradigm
Heterogeneous responses to changes in dietary salt intake: The salt-sensitivity paradigm
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DOI：
10.1093/ajcn/65.2.612s
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发表时间：
1997-01-01
影响因子：
7.1
通讯作者：
Weinberger, Myron H.
中科院分区：
文献类型：
--
作者：
Luft, Friedrich C.;Weinberger, Myron H.
血压对膳食盐摄入量增加和减少的反应是不同的。对于一些高血压患者来说，限制盐摄入可以降低血压，具有临床意义，并且可以达到药物治疗的效果。在其他情况下，血压几乎没有变化，而在另一些情况下，血压实际上可能会因限制盐而升高。异质反应部分是后天获得的，涉及年龄的影响、其他电解质的摄入以及某些药物的影响。遗传倾向也可能发挥重要作用，因为黑人和非胰岛素依赖型糖尿病患者对盐的敏感性增加。一些不常见但易于诊断的盐敏感遗传综合征，例如糖皮质激素可治愈的醛固酮增多症和利德尔综合征，已经被发现。短期体积扩张和收缩以及长期饮食干预似乎具有可重复性，可用于识别盐敏感和耐盐个体；然而，这些操作很麻烦并且不能大规模使用。目前还没有用于识别盐敏感性和盐抗性原发性高血压个体的分子遗传学技术，但如果假定的基因多态性被识别，此类技术可能会取代当前的试错方法。
Blood pressure responses to increases and decreases in dietary salt intake are heterogeneous. In some hypertensive individuals, decreases in blood pressure with salt restriction are clinically significant and approach that achieved with medication. In others, little or no change in blood pressure occurs, whereas in still others, blood pressure may actually increase with salt restriction. The heterogeneous responses are partly acquired and involve the influences of age, the intake of other electrolytes, and the influence of certain medications. Genetic predisposition may also play a substantial role because salt sensitivity is increased in black individuals and in persons with non-insulin-dependent diabetes mellitus. Some uncommon but readily diagnosed salt-sensitive genetic syndromes, such as glucocorticoid-remediable aldosteronism and Liddle syndrome, have been identified. Short-term volume expansion and contraction and longer-term dietary interventions appear to be reproducible and may be used to identify salt-sensitive and salt-resistant individuals; however, these maneuvers are cumbersome and cannot be used on a large scale. Molecular genetic techniques for identifying individuals with salt-sensitive and salt-resistant essential hypertension are not yet available, but if the putative gene polymorphisms are identified, such techniques may replace the current trial-and-error methods.