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Study of pathogenesis of salt-sensitive hypertension: Japan-US cooperative study

盐敏感性高血压发病机制研究：日美合作研究

基本信息

批准号：
02670396
负责人：
MATSUURA Hideo
金额：
$ 1.41万
依托单位：
HIROSHIMA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1991
项目状态：
已结题

项目摘要

On the diagnostic criteria of non-modulator, who concomitantly fails to modulate the adrenal and the renovascular responses to change in sodium chloride intake, in white patients with normal-renin essential hypertension (NR-EHT) by G.H.Williams et al. (Harvard Medical School, Boston, MA), we examined the incidence of non-modulator in Japanese patients with NR-EHT and the relation between non-modulation and salt sensitivity. Eighteen out of 21 patients with HET were diagnosed as NR-EHT. A preliminary study performed on 5 normotensive sudjects showed the criteria were applicable to Japanese subjects. Sodium chloride balance study, 250 mEg NaCl a day for a week (high sodium period) followed by 10 mEg NaCl a day for a week (low sodium period), were performed and on the last day of each period the renovascular and the adrenal responses to 3.0 ng/Kg/min of angiotensin II(AII) were examined. The decrease in renal plasma flow (RPF) by AII measured by para-aminohippurate clearance less than 120 … More ml/min/1.73m^2 in the high sodium period was designated as non-modulator of the renovascular system. The increase in plasma aldosterone concentration(PAC) by AII less than 150 pg/ml in the low sodium period was designated as non-modulator of the adrenal gland. The incidence of non-modulator in Japanese patients with NR-EHT was 16.7%(3/18) by the renovascular response or 61.1%(11/18) by the adrenal response. There were only three patients who were diagnosed non-modulator by the both criteria concomitantly. The incidence of non-modulator in Japanese diagnosed by the adrenal response was similar to that in the United States. There was no significant differences in changes of RPF, PAC, serum electrolytes, erythrocytic Na transport systems, platelet AII receptor and Ca-regulating hormones with sodium chloride balance study between modulator and non-modulator. Salt sensitivity (change in mean blood pressure from high to low sodium period) showed negative correlation with changes in the adrenal response to AII from high to low sodium period, but not with those in renovascular response, Na transport systems, platelet AII receptor, Ca-regulating hormones.In summary, it was suggested that in Japanese patients with NR-EHT modulation of adrenal gland and renovascular system was independent each other. The incidence of non-modulator in Japanese patients with NR-EHT diagnosed by adrenal response to extrinsic AII was 61% and similar to that in the United States. Modulation of the adrenal gland may play some role on salt sensitivity in patients with NR-EHT. Less

根据G.H.威廉姆斯等人（哈佛医学院，波士顿，MA）在患有正常肾素原发性高血压（NR-EHT）的白色患者中的非调节剂诊断标准，我们检查了日本NR-EHT患者中非调节剂的发生率以及非调节剂与盐敏感性之间的关系。21例HET患者中有18例诊断为NR-EHT。对5例血压正常的糖尿病患者进行的初步研究显示，该标准适用于日本受试者。进行氯化钠平衡研究，每天250 mEg NaCl持续一周（高钠期），然后每天10 mEg NaCl持续一周（低钠期），并在每个阶段的最后一天检查肾血管和肾上腺对3.0 ng/Kg/min血管紧张素II（AII）的反应。通过对氨基马尿酸清除率测量的AII肾血浆流量（RPF）降低小于120 ...更多信息在高钠期以ml/min/1.73m^2的速率为肾血管系统的非调节剂。在低钠期，AII使血浆醛固酮浓度（PAC）升高小于150 pg/ml，被指定为肾上腺非调节剂。根据肾血管反应，日本NR-EHT患者中非调节剂的发生率为16.7%（3/18），根据肾上腺反应，非调节剂的发生率为61.1%（11/18）。只有3例患者同时根据两项标准被诊断为非调节剂。通过肾上腺反应诊断的日本非调节剂的发生率与美国相似。调节剂组与非调节剂组的RPF、PAC、血清电解质、红细胞钠转运系统、血小板AII受体和钙调节激素的变化无显著性差异。盐敏感性（从高钠期到低钠期平均血压的变化）与肾上腺对AII反应性从高钠期到低钠期的变化呈负相关，而与肾血管反应性、钠转运系统、血小板AII受体、钙调节激素的变化无相关性，提示日本NR-EHT患者肾上腺和肾血管系统的调节是相互独立的。通过肾上腺对外源性AII的反应诊断的NR-EHT日本患者中非调节剂的发生率为61%，与美国相似。肾上腺的调节可能在NR-EHT患者的盐敏感性中起一定作用。少