Suzuki M, Kimura Y, Tsushima M, Harano Y
Division of Atherosclerosis, Metabolism and Clinical Nutrition, Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Hypertension. 2000 Apr;35(4):864-8. doi: 10.1161/01.hyp.35.4.864.
Insulin resistance was demonstrated in hypertensive patients and in salt-sensitive subjects. It was recently reported that the salt-sensitive state was related to a reduced fall in blood pressure during the night in essential hypertension. In the present study, the relationship among insulin sensitivity, blood pressure response to salt intake, and nocturnal fall in blood pressure was examined in 20 subjects with nondiabetic and nonobese essential hypertension during a low-salt and a high-salt diet. The subjects were maintained on a low-salt diet (50 mmol/d) and a high-salt diet (255 mmol/d) for 1 week each, in random order. On the sixth day of each diet, blood pressure was measured every hour for 24 hours with an automatic device. Insulin sensitivity was measured according to the steady-state plasma glucose (SSPG) method on the seventh day of each diet. Salt-induced increase in blood pressure, which we defined as the change in 24-hour mean arterial pressure between the low and the high dietary salt intakes, was significantly correlated with SSPG (r=0.60, P<0.01) during the high-salt period. There was a significant negative correlation (r=-0.61, P<0.01) between SSPG and a nocturnal fall in mean arterial pressure during the high-salt period. Salt-induced increase in blood pressure was inversely correlated with a nocturnal fall in mean arterial pressure (r=-0.52, P<0.02) with the high-salt diet. These results suggest that insulin resistance, salt sensitivity, and failed nocturnal fall in blood pressure are associated with each other in subjects with essential hypertension.
高血压患者和盐敏感个体中存在胰岛素抵抗。最近有报道称，在原发性高血压中，盐敏感状态与夜间血压下降减少有关。在本研究中，对20例非糖尿病、非肥胖的原发性高血压患者在低盐和高盐饮食期间胰岛素敏感性、血压对盐摄入的反应以及夜间血压下降之间的关系进行了研究。受试者随机先后接受低盐饮食（50 mmol/d）和高盐饮食（255 mmol/d）各1周。在每种饮食的第6天，使用自动设备每小时测量一次血压，共测量24小时。在每种饮食的第7天，根据稳态血浆葡萄糖（SSPG）法测量胰岛素敏感性。在高盐期，我们将盐诱导的血压升高定义为低和高饮食盐摄入量之间24小时平均动脉压的变化，其与SSPG显著相关（r = 0.60，P < 0.01）。在高盐期，SSPG与平均动脉压的夜间下降之间存在显著负相关（r = -0.61，P < 0.01）。高盐饮食时，盐诱导的血压升高与平均动脉压的夜间下降呈负相关（r = -0.52，P < 0.02）。这些结果表明，在原发性高血压患者中，胰岛素抵抗、盐敏感性和夜间血压下降异常相互关联。
