PREDICTION OF SALT SENSITIVITY
PREDICTION OF SALT SENSITIVITY
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DOI：
10.1093/ajh/3.6.429
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发表时间：
1990-06-01
影响因子：
3.2
通讯作者：
BERRY, C
中科院分区：
文献类型：
--
作者：
DIMSDALE, JE;ZIEGLER, M;BERRY, C
盐敏感性的总体患病率在75名男性中进行了研究，这些男性按诊断（高血压与血压正常）和种族（黑人与白色）分层。所有研究均采用交叉设计，采用200 mEq和10 mEq Na/天。高盐导致所有组的舒张压降低（P <0.002）。对于收缩压，在整个组中没有盐对血压的影响;然而，在高血压患者中，特别是黑人高血压患者，高盐导致收缩压升高（P <0.022）。肥胖患者更可能因盐负荷而增加收缩压（P <0.05）。高盐时血压升高的患者是那些对盐负荷反应较少的血浆去甲肾上腺素和肾素水平下降的患者（均P <0.05）。通过一个多元回归方程，以较高的统计功效（R = 0.689，P <0.00001）预测了对盐的敏感性：种族;诊断;饮食中的肾素和去甲肾上腺素水平的变化;以及两种饮食中BP对输注去甲肾上腺素的敏感性的变化。鉴于低盐会增加去甲肾上腺素、肾素和舒张压，以及与收缩期盐敏感性相关的特定生理和流行病学背景，人们想知道对所有高血压患者全面推荐低盐饮食的可行性。
The overall prevalence of salt sensitivity was studied in 75 men stratified by diagnosis (hypertensive v normotensive) and race (black v white). All were studied in a crossover design employing a 200 mEq and 10 mEq Na/day. High salt led to a decrease in diastolic pressure for all groups (P < .002). For systolic pressure, there was no salt effect on blood pressure across the whole group; however amongst the hypertensives, particularly the black hypertensives, high salt led to increases in systolic pressure (P < .022). Obese patients were more likely to increase their systolic pressure in response to salt loading (P < .05). The patients whose pressure increased on high salt were those who manifested less of a decrease in plasma levels of norepinephrine and renin in response to salt loading (both P < .05). Systolic salt sensitivity was predicted with high statistical power (R = 0.689, P < .00001) by a multiple regression equation employing: race; diagnosis; the change in renin and norepinekphrine levels with diet; and the change in BP sensitivity to infused norepinephrine across the two diets. In view of the findings of increased norepinephrine, renin and diastolic pressure on low salt and in view of the particular physiological and epidemiological setting associated with systolic salt sensitivity, one wonders about the advisability of across-the-board recommendations of low salt diets for all hypertensive patients.