Pathogenesis of hypertension and interraction of vasoactive hormones

对原发性高血压患者进行高钠饮食，观察血压与各种血管活性激素的相互作用。盐敏感患者去甲肾上腺素抑制和PGE2升高不足。在盐平衡研究中，正常受试者的PRA与PGE2呈线性关系，而高血压患者的PRA与PGE2的关系受到干扰。高钠饮食高血压患者补充钾可降低血压，钾的降压作用与钠负荷引起的血压升高幅度相关。高钾摄入时PGE2升高至少部分参与了降压机制。口服补钙8周可降低老年高血压患者血压。血压降低的机制是多因素的。抑制血浆vit。PTH降低后的D3被认为是其机制之一，表明细胞内钙离子在高血压维持中的重要性。在原发性高血压患者中，通过RIA和Na抑制法测定循环瓦巴因样因子，k - atp酶抑制均因钠负荷而增加。血浆华阿拜样抑制剂水平与血压和尿钠排泄相关。提示内源性乌阿拜样钠泵抑制剂在高钠摄入致高血压的病理生理中起重要作用。目前正在对该因素进行分离和鉴定。一种敏感的人肾素RIA已被开发用于临床应用。该抗体可识别活性和失活的肾素，通过RIA测定的肾素水平表达总肾素。该方法为R-A的研究提供了一种新的工具。

Patients with essential hypertension were placed on high sodium diet and BP and various vasoactive hormonal interaction were observed.Suppression of norepinephrine and increase in PGE2 wereinsufficient in salt-sensitive patients.The relationship between PRA and PGE2 during salt balance study was linear in normotensive subjects,however the rellation was disturbed in hypertensive patients.Potassium supplement lowered BP in hypertensive patients with high sodium diet and hypotensive effects of potassium correlated with the magnitude of BP increase caused by sodium loading.Increased PGE2 during high K intake involved at leaset partially in the hypotensive mechanism.Oral calcium loading for 8 weeks lowered BP in elderly hypertensive patients.The mechanism of BP reduction is multifactorial.Suppression of plasma vit.D3 following reduction of PTH is suggested as one of the mechanism,indicating the inportance of intracellular Ca ion in the maintenance of hypertension.Circulating ouabain-like factor determined by both RIA and the method of inhibition of Na,K-ATPase inhibition was incresed by sodium loading in patients with essential hypertension.Plasma level of ouabain-like inhibitor correlated with both BP and urinary sodium excretion.Thus it is suggested that the endogenous ouabain-like sodium pump inhibitor plays an important role in the pathophysiology of high blood pressure induced by high sodium intake.Isolation and identification of this factor in now in progress.A sensitive human renin RIA has been developed for clinical use.The antibody recognize both active and inactive from of renin and renin level measured by this RIA express total renin. This method provides a new tool for the R-A study.