MODERATE SODIUM RESTRICTION WITH ANGIOTENSIN CONVERTING-ENZYME-INHIBITOR IN ESSENTIAL-HYPERTENSION - A DOUBLE-BLIND-STUDY
MODERATE SODIUM RESTRICTION WITH ANGIOTENSIN CONVERTING-ENZYME-INHIBITOR IN ESSENTIAL-HYPERTENSION - A DOUBLE-BLIND-STUDY
复制标题
DOI：
10.1136/bmj.294.6571.531
复制
发表时间：
1987-02-28
影响因子：
105.7
通讯作者：
SAGNELLA, GA
中科院分区：
文献类型：
--
作者：
MACGREGOR, GA;MARKANDU, ND;SAGNELLA, GA
15例未选择的原发性高血压患者，在未接受任何治疗时平均仰卧位血压为162/107 mm Hg，每日两次，使用卡托普利50 mg。经过一个月的治疗，他们的仰卧位血压降至149/94毫米汞柱，然后指示他们将钠摄入量减少到约80毫摩尔(mEq)/天。在两周的适度钠限制后，他们进入了一项双盲随机交叉研究，比较10片慢钠片（100毫摩尔氯化钠）与相应的安慰剂片的效果，同时继续服用卡托普利并限制饮食中的钠。服用安慰剂1个月后，他们的平均仰卧血压为137/88 mm Hg，尿钠排泄量为83 mmol/24 h，而服用慢钠片1个月后，他们的平均仰卧血压为150/97 mm Hg (p < 0.001)，钠排泄量为183 mmol/24 h。因此，适度限钠期间的平均仰卧血压下降了9%，并与尿钠排泄量的减少显著相关。这些结果表明，适度但实际地减少钠摄入量和血管紧张素转换酶抑制剂的联合治疗对降低原发性高血压患者的血压是有效的。这种结合的方法克服了对单独限制盐和单独转化酶抑制剂的一些反对意见。
Fifteen unselected patients who had essential hypertension and whose average supine blood pressure when they were not receiving any treatment and their usual sodium intake was 162/107 mm Hg were treated with captopril 50 mg twice daily. After one month''s treatment their supine blood pressure had decreased to 149/94 mm Hg. They were then instructed to reduce their sodium intake to about 80 mmol(mEq)/day. After two weeks of moderate sodium restriction they were entered into a double blind randomised crossover study comparing the effect of 10 Slow Sodium tablets (100 mmol sodium chloride) with matching placebo tablets while continuing to take captopril and restrict sodium in their diet. After one month of taking placebo their mean supine blood pressure was 137/88 mm Hg with a urinary sodium excretion of 83 mmol/24 h, while after one month of taking Slow Sodium tablets their mean supine blood pressure was 150/97 mm Hg (p < 0.001) with a sodium excretion of 183 mmol/24 h. The mean supine blood pressure during moderate sodium restriction therefore decreased by 9% and correlated significantly with the reduction in urinary sodium excretion. These results suggest that the combination of treatment with a moderate but practical reduction in sodium intake and an angiotensin converting enzyme inhibitor is effective in decreasing the blood pressure in patients with essential hypertension. This combined approach overocmes some of the objections that have been made to salt restriction alone and to converting enzyme inhibitors alone.