Dietary sodium and target organ damage in essential hypertension
Dietary sodium and target organ damage in essential hypertension
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DOI：
10.1016/s0895-7061(01)02287-7
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发表时间：
2002-03-01
影响因子：
3.2
通讯作者：
Mimran, A
中科院分区：
文献类型：
--
作者：
du Cailar, G;Ribstein, J;Mimran, A
除了对动脉压产生广泛争议的影响外，膳食钠还可能对人类左心室质量产生一些与压力无关的影响。在本研究中，我们假设钠摄入量（通过连续两次测量 24 小时尿钠排泄量来估计）可能会放大动脉压对一大群血压正常受试者和从未治疗过的单纯性原发性高血压患者的靶器官损伤（即左心室质量和微量白蛋白尿）的影响。对 839 名年龄 15 至 70 岁、动脉压升高 (60%) 或正常的受试者（471 名男性和 368 名女性）进行了左心室质量（M 型超声心动图）和尿白蛋白排泄量的评估。在整个人群中，多变量分析表明，尿钠排泄量与左心室质量指数（β = 0.02，P < .01）以及尿白蛋白排泄量（β = 0.001，P < .0001）之间的关系与性别、年龄、体重指数和收缩动脉压无关。当根据尿钠排泄将受试者分为五分位数时，尽管收缩动脉压值相似，但两种性别的左心室质量指数和尿白蛋白排泄量从最低五分位数到最高五分位数显着增加。在尿钠排泄的每个五分位数内获得的将收缩动脉压与左心室质量指数（男性）和尿白蛋白排泄（整个人群）联系起来的回归线的斜率从最低到最高五分位数逐渐线性增加。这些结果表明，钠摄入量可能会放大动脉压对左心室和肾脏的影响，从而表明膳食钠可能是心血管风险的独立因素。 Am J Hypertens 2002；15:222-229 (C) 2002 美国高血压杂志有限公司。
In addition to its widely contested influence on arterial pressure, dietary sodium may exert some nonpressure-related effects on left ventricular mass in humans. In the present study, we hypothesized that sodium intake (estimated by two consecutive measurements of 24-h urinary sodium excretion) may amplify the effect of arterial pressure on target organ damage (ie, left ventricular mass and microalbuminuria) in a large group of normotensive subjects and patients with never-treated uncomplicated essential hypertension. Left ventricular mass (M-mode echocardiography) and urinary albumin excretion were assessed in 839 subjects (471 men and 368 women) aged 15 to 70 years, with elevated (60%) or normal arterial pressure. In the entire population, multivariate analysis indicated that the relationship between urinary sodium excretion and left ventricular mass index (beta = 0.02, P < .01) as well as urinary albumin excretion (beta = 0.001, P < .0001) was independent from sex, age, body mass index, and systolic arterial pressure. When subjects were divided into quintiles according to urinary sodium excretion, left ventricular mass index and urinary albumin excretion increased significantly from the lowest to the highest quintile in both genders, despite similar values of systolic arterial pressure. The slope of the regression line linking systolic arterial pressure to left ventricular mass index (in men) and urinary albumin excretion (in the entire population) obtained within each quintile of urinary sodium excretion, progressively and linearly increased from the lowest to the highest quintile. These results suggest that sodium intake may amplify the effect of arterial pressure on both the left ventricle and the kidney, and thus suggest that dietary sodium may be an independent factor of cardiovascular risk. Am J Hypertens 2002;15:222-229 (C) 2002 American Journal of Hypertension, Ltd.