SODIUM SENSITIVITY OF BLOOD PRESSURE

高血压是心脑血管的主要危险因素 疾病，轻度高血压患者占大多数， 发病率。 对这些患者的治疗是有争议的，因为 药物治疗的结果令人失望。 膳食钠 限制饮食和补充钙是降低血液 一些高血压患者的血压。 本申请的目的 是为了确定限钠的有效性和可行性， 在社区高血压人群中补充钙， 确定这两种离子的相互关系，并测试 来预测对这些干预措施的反应。 的 要研究的标记物是 肾素-血管紧张素系统，钙和镁代谢指数，以及 心房利钠因子 随机样本（250例患者）将从以下人群中选择： 高血压患者在工作场所的高血压治疗 程序. 基线评估将通过VB进行，然后进行为期四周的 高钠和低钠摄入量，每种摄入量之前都将有四周的 高钠和低钠摄入期，每一个时期之前都将有一个 四周内摄入中等量的钠。 高低的顺序 随机分配含钠饮食。 同样的受试者将进入 一项安慰剂对照的交叉研究， 补充，每个阶段持续三个月。 对血液的影响 将通过在工作场所测量血压、家庭血压 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 钙和钠摄入量的变化对工作和家庭的影响 压力，提供其对血压影响的指数 反应性 钠敏感性与钙敏感性的关系 将被评估。 血浆肾素活性基线水平的能力， 急性转化酶抑制的肾素反应，基线水平 血清离子钙和镁，以及心房肌收缩压的基线水平 利钠因子来预测钠和 将评估钙的摄入量，以及饮食的影响。 对这些参数的操作。 这样做的结果应该是 为卫生保健工作者提供新的、实用的和安全的能力 在大规模人群中控制血压的方法。

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.