Hypotensive mechanism induced by calorie restriction in overweight hypertensive patients

本研究旨在探讨钠摄入对10例超重原发性高血压患者限制热量摄入引起的血压下降的影响。他们接受了一周的低钠饮食，每天含有2 g NaCl，然后再换成一周的高钠饮食，每天含有12 g NaCl。然后他们接受低热量饮食（450千卡/天）2-3周。在初始体重减轻后，重复钠限制和负荷。在每个饮食期结束时测量24小时动态血压。低热量饮食的平均体重减轻为6.0*2.8 kg，这使低钠饮食下的平均血压从103*13 mmHg显着降低至98*13 mimHg。体重减轻与高钠饮食下血压从107*16 mmHg降至10*716 mmHg无关。因此，体重减轻显著增加了血压的盐敏感性，从4 mmHg增加到9 mmHg。低钠饮食和高钠饮食组大鼠血浆肾素活性、尿醛固酮和去甲肾上腺素排泄量的变化在体重下降前显著高于体重下降后。FFI的结论是，热量限制显著降低了血压。过量的钠摄入似乎通过增加盐敏感性来减弱有利的效果。建议对超重的原发性高血压患者进行限钠减肥以降低血压。

The present study was conducted to determine the effect of sodium intake on the blood pressure decrease induced by calorie restriction in 10 overweight patients with essential hypertension. They received a low sodium diet containing 2 g of NaCI/day for a week, and were then switched to a high sodium diet that contained 12 g per day for another week. They then received a low calorie diet (450 kcal/day) for 2-3 weeks. After the initial weight loss, sodium restriction and loading were repeated. The 24-hour ambulatory blood pressure was measured at the end of each dietary period. Mean weight loss on the low calorie diet was 6.0*2.8 kg, which significantly reduced the mean blood pressure under the low sodium diet from 103*13 mmHg to 98*13 mimHg. Weight loss was not associated with the reduction in blood pressure under the high sodium diet from 107*16 mmHg to 10*716 mmHg. Thus, weight loss significantly increased the salt-sensitivity of blood pressure from 4 mmHg to 9 mmHg. The change in plasma renin activity and urinary excretions of aldosterone and norepinephrine between lowsodium diet and high sodium diet was significantly higher in pre-weight loss than post-weght loss. ffi conclusion, calorie restriction significantly decreased the blood pressure. Excess sodium intake appeared to blunt the favourable effect via an increase in salt-sensitivity. Weght loss with sodium restriction is recommended for reducing the blood pressure of overweight patients with essential hypertension.