SODIUM AND CALCIUM SENSITIVITY OF BLOOD PRESSURE

高血压是心脑血管疾病的主要危险因素。 疾病，轻度高血压患者占大多数 发病率。这些患者的治疗是有争议的，因为 药物治疗的结果一直令人失望。膳食钠 限制和补钙是降低血液的干预措施 一些高血压患者的血压。本应用程序的目标是 是为了确定钠限制的有效性和可行性 在社区高血压人群中补充钙，以 确定这两个离子的相互关系，并测试其能力 以预测对这些干预措施的反应。这个 要调查的标志物是酶的活性和反应性 肾素-血管紧张素系统，钙和镁代谢指标，以及 心钠素。 随机样本(250名患者)将从一大群人中选出 高血压患者从高血压病到工作场所的治疗 程序。基线评估将在四周的时间内进行 高钠和低钠摄入量，每一次之前都会有四周的 高钠摄入量和低钠摄入量的时期，每个时期之前都会有一个 四个星期的中等钠摄入量。高与低的顺序 钠饮食将被随机分配。同样的受试者将会进入 口服钙剂作用的安慰剂对照交叉研究 补充，每个阶段持续三个月。对血液的影响 压力将通过在工作现场的测量、家庭血液进行评估 血压记录和24小时动态血压监测。 24小时血压监测将允许比较 钙、钠摄入量变化对工作和家庭的影响 血压，提供了它们对血压影响的指数 反应性。钠敏感性与钙敏感性的关系 将会被评估。血浆肾素活性的基线水平， 肾素对急性转换酶抑制的反应，基线水平 血清游离钙、镁和心房肌基础水平 用利钠因子预测推拿钠和钠的反应 将评估钙的摄入量，以及饮食的影响。 对这些参数的操纵。这样做的结果应该是 为医护人员提供新的、实用的和安全的能力 在大量人群中控制血压的手段。

Hypertension is a major risk factor for cardiovascular and cerebrovascular disease, and patients with mild hypertension account for the majority of the morbidity. The treatment of these patients is controversial because the results of drug therapy have been disappointing. Dietary sodium restriction and calcium supplementation are interventions that lower blood pressure in some hypertensive patients. The objective of this application is to determine the effectiveness and feasibility of sodium restriction and calcium supplementation in a community based hypertensive population, to determine the interrelationship of these two ions, and to test the ability of several markers to predict the response to these interventions. The markers to be investigated are the activity and reactivity of the renin-angiotensin system, indices of calcium and magnesium metabolism, and atrial natriuretic factor. A random sample (250 patients) will be selected from a large population of hypertensive patients from a Hypertension at the Worksite Treatment Program. A baseline evaluation will vb followed by four week periods of high and low sodium intake, each of which will be preceded by a four week periods of high and low sodium intake, each of which will be preceded by a four week period on a medium sodium intake. The order of high and low sodium diets will be randomly assigned. The same subjects will then enter a placebo controlled crossover study of the effects of oral calcium supplementation, each phase lasting three months. The effects on blood pressure will be assessed by measurement at the worksite, home blood pressure recordings, and 24 hour ambulatory blood pressure monitoring. Twenty-four hour blood pressure monitoring will allow comparison of the effects of the changes in calcium and sodium intake on work and home pressures, providing an index of their effects on blood pressure reactivity. The relationship of sodium sensitivity to calcium sensitivity will be assessed. The ability of baseline levels of plasma renin activity, renin response to acute converting enzyme inhibition, baseline levels of serum ionized calcium and magnesium, and baseline levels of atrial natriuretic factor to predict the response to manipulation of sodium and calcium intakes will be assessed, as will the effect of the dietary manipulations on these parameters. Results of this should have the capability for providing to health care workers new, practical and safe means for blood pressure control in large populations.