Association between salt sensitivity and target organ damage in essential hypertension
Association between salt sensitivity and target organ damage in essential hypertension
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DOI：
10.1016/s0895-7061(00)00253-3
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发表时间：
2000-08-01
影响因子：
3.2
通讯作者：
Akoglu, E
中科院分区：
文献类型：
--
作者：
Bihorac, A;Tezcan, H;Akoglu, E
钠敏感的原发性高血压患者更容易发生心血管事件;最近，钠敏感性被证明是独立于其他经典因素（如血压和吸烟）的心血管危险因素。本研究探讨了高血压患者盐敏感性状态与靶器官损害之间的关系。研究了96例中度原发性高血压患者（35例男性，61例女性）的盐敏感性状态和靶器官损害的存在，包括高血压性视网膜病变、血清肌酐、肌酐清除率和尿白蛋白排泄（UAE）。根据超声心动图左室重量指数和相对室壁厚度将患者分为四种不同的左室解剖适应模式。45例（47%）患者显示为盐敏感，而51例（53%）为耐盐受试者。盐敏感性高血压组的血清肌酐和UAE显著高于盐敏感性高血压组（分别为P <0.05和P <0.001）。盐敏感性高血压组的左心室重量指数（LVMI）、相对室壁厚度（RWT）和左心房指数（LAI）均显著增高。向心性肥大在盐敏感组中明显更普遍（37.8%对11.8%; P <0.01）。盐敏感组高血压视网膜病变的患病率为84.4%，而盐耐受组为59.6%（P <0.01）。多元回归分析显示盐敏感性是LVMI、RWT和UAE的重要预测因子，与年龄、体重指数和平均血压无关。总之，盐敏感性高血压患者更容易发生严重的高血压靶器官损害，这可能会增加他们的肾脏和心血管疾病的发病风险。(C)2000年美国高血压杂志有限公司
Cardiovascular events occur more frequently in sodium-sensitive patients with essential hypertension; recently, sodium sensitivity was shown to be a cardiovascular risk factor independently of other classic factors such as blood pressure and cigarette smoking This study examined the relationship between salt sensitivity status and target organ damage in hypertensive patients. Ninety-six patients (35 men, 61 women) with moderate essential hypertension were studied for salt sensitivity status and the presence of target organ damage, including hypertensive retinopathy, serum creatinine, creatinine clearance, and urinary albumin excretion (UAE). Four different patterns of left ventricular anatomic adaptation were identified by categorizing patients according to the values of left ventricular mass index and relative wall thickness by the means of echocardiography. Forty-five (47%) patients were shown to be salt-sensitive, in contrast to 51 (53%) salt-resistant subjects. Serum creatinine and UAE were significantly higher in the group of salt-sensitive hypertensives (P < .05 and P < .001, respectively). Left ventricular mass index (LVMI), relative wall thickness (RWT), and left atrial index (LAI) were all significantly higher in the group of salt-sensitive hypertensive patients. Concentric hypertrophy was significantly more prevalent in the salt-sensitive group (37.8% v 11.8%; P < .01). The prevalence of hypertensive retinopathy in the salt-sensitive group was 84.4%, in contrast to 59.6% in the salt-resistant group (P < .01). Multivariate regression analysis revealed salt sensitivity as a significant predictor of LVMI, RWT, and UAE, independently of age, body mass index, and mean blood pressure. In conclusion, salt-sensitive hypertensive patients are more prone to develop severe hypertensive target organ damage that may enhance their risk of renal and cardiovascular morbidity. (C) 2000 American Journal of Hypertension, Ltd.