Blood pressure is linked to salt intake and modulated by the angiotensinogen gene in normotensive and hypertensive elderly subjects
Blood pressure is linked to salt intake and modulated by the angiotensinogen gene in normotensive and hypertensive elderly subjects
复制标题
DOI：
10.1097/00004872-200106000-00009
复制
发表时间：
2001-06-01
影响因子：
4.9
通讯作者：
Davis, D
中科院分区：
文献类型：
--
作者：
Johnson, AG;Nguyen, TV;Davis, D
目的评价不同类型高血压老年患者和对照组的盐敏感性，并研究基因型对盐敏感性的调节作用。设计随机、双盲、安慰剂对照的拉丁方试验。收缩压（SBP）≥ 160，舒张压（DBP）< 90 mmHg，n =191，舒张期和收缩期高血压（SDH; DBP大于或等于90 mmHg，n =10）和正常血压（SBP < 160，DBP < 90 mmHg，n = 17）。干预：四个14天的治疗，50，100，200和300毫摩尔/天的氯化钠补充，穿插14天的洗出期，限盐饮食。结果对于整个队列，对于50、100、200和300 mmol/d盐，SEP从基线变化的平均标准误（SE）分别为7.7 +/-2.4，12.1 +/-2.4，12.1 +/-2.4，12.2 +/-2.4，分别为16.6 ± 3.0、18.5 ± 2.6 mmHg。对于DBP，相应变化为：-0.1 +/- 1.5、2.4 +/- 1.6、3.0 +/- 1.5、5.8 +/- 1.7 mmHg。ISH组SEP的增幅显著高于SDH组和正常血压组（P < 0.05）。AGT基因型影响盐剂量对DBP的影响（P= 0.006），但不影响SEP的影响（P= 0.7）。结论在健康老年人中，随着盐剂量的增加，血压呈线性增加，在ISH患者中表现得最为明显，AGT基因型可调节血压的变化。
Objectives To evaluate salt sensitivity in elderly subjects with different forms of hypertension and controls and to investigate any modulation by genotypeDesign Randomized, double-blinded, placebo-controlled latin-squareSetting Tertiary referral hospitalParticipants Community subjects (n = 46) aged greater than or equal to 60 years classified as isolated systolic hypertension [ISH; systolic blood pressure (SBP)greater than or equal to 160, diastolic blood pressure (DBP)< 90 mmHg, n =191, diastolic a systolic hypertension (SDH; DBP greater than or equal to 90 mmHg, n =10)and normotension (SBP < 160, DBP < 90 mmHg, n = 17).Intervention: Four 14 day treatments, 50, 100, 200 and 300 mmol/day of sodium chloride supplementation interspersed with 14 day washout periods on a salt-restricted diet.Main outcome measures The 24 h blood pressure, heart rate, weight, urinary sodium and creatinine clearance measured during baseline, treatment and washout periods and angiotensinogen (AGT) and angiotensin converting enzyme(ACE)genotypes.Results For the entire cohort, the mean a standard error (SE) of change from baseline in SEP for 50, 100, 200 and 300 mmol/day salt was 7.7 +/- 2.4, 12.1 +/- 2.4, 16.6 +/- 3.0, 18.5 +/- 2.6 mmHg, respectively. For DBP, the respective changes were: -0.1 +/- 1.5, 2.4 +/- 1.6, 3.0 +/- 1.5, 5.8 +/- 1.7 mmHg. The increase in SEP among ISH subjects was significantly higher than among subjects in the SDH and normotensive groups (P < 0.05). AGT genotype influenced the effect of salt dose on the change in DBP (P= 0.006) but not SEP (P= 0.7).Conclusions In healthy, older subjects, a linear increase in BP occurred with increasing salt dose, it appeared most pronounced in ISH subjects and could be modulated by AGT genotype.