HORMONAL RESPONSES TO SALT IN NORMAL AND ESSENTIAL HYPERTENSION

在以前的正常肾素原发性高血压的研究中， 鉴定 一个子集显示血压的盐敏感性， 血浆肾素活性低于正常刺激，尿多巴胺正常， 超常累积钠潴留，血浆中无变化 去甲肾上腺素的作用 另一个子集显示， 血压盐不敏感，血浆肾素刺激正常 活动，超常尿多巴胺，正常累积钠潴留 高钠血症时血浆去甲肾上腺素显著减少 摄入 由于平均尿多巴胺与 累积钠潴留和血浆中的百分比变化 去甲肾上腺素，这两个子集之间的差异似乎是 部分归因于多巴胺能活性的差异。 结果 对正常受试者的类似研究表明， 高血压患者，表现出血压盐敏感性的现象。 与耐盐正常人相比，盐敏感正常人 受试者具有较低的刺激血浆肾素活性， 多巴胺，更大的累积钠潴留和更高的血浆 去甲肾上腺素对高钠反应的变化较小 摄入 这些初步发现表明，盐敏感的正常受试者 与盐敏感性高血压患者在性质上相似， 许多方面和许多代表人口的发展风险， 盐敏感性原发性高血压 研究结果还表明， 盐敏感性高血压受试者的特征 代表正常生理学的改变， 是高血压过程的结果

In previous studies of normal renin essential hypertension two subsets were identified. One subset showed salt-sensitivity of blood pressure, subnormal stimulation of plasma renin activity, normal urinary dopamine, supranormal cumulative sodium retention and no change in plasma norepinephrine during a high sodium intake. The other subset showed salt-insensitivity of blood pressure, normal stimulation of plasma renin activity, supranormal urinary dopamine, normal cumulative sodium retention and a significant decrease in plasma norepinephrine during a high sodium intake. Since mean urinary dopamine correlated inversely with both cumulative sodium retention and the percent change in plasma norepinephrine, the differences between these two subsets appeared to be attributable, in part, to differences in dopaminergic activity. Results of similar studies of normal subjects indicate that some, like the hypertensives, show the phenomenon of salt-sensitivity of blood pressure. Compared to the salt-resistant normal subjects the salt-sensitive normal subjects had a lower stimulated plasma renin activity, lower urinary dopamine, greater cumulative sodium retention and a higher plasma norepinephrine that showed a smaller change in response to a high sodium intake. These initial findings suggest that salt-sensitive normal subjects are qualitatively similar to patients with salt-sensitive hypertension in many respects and many represent the population at risk for development of salt-sensitive essential hypertension. The results also suggest that many features that characterize the salt-sensitive hypertensive subjects represent modifications of normal physiology and do not appear to be acquired as a consequence of the hypertensive process.