Lopes H F, Stojiljkovic M P, Zhang D, Goodfriend T L, Egan B M
Department of Pharmacology, Medical University of South Carolina, Charleston, SC 29425, USA.
J Clin Hypertens (Greenwich). 2002 May-Jun;4(3):173-80. doi: 10.1111/j.1524-6175.2002.00712.x.
The effect of dietary sodium restriction on insulin, lipids, and blood pressure has been controversial. Evidence suggests that adverse short-term effects in response to very low-salt diets do not persist long-term with modest sodium restriction. In this study, the effects of modest dietary sodium restriction (60 and 120 mmol sodium) were measured for 3 weeks in 12 lean normotensives and 10 obese hypertensives. Blood pressure, plasma lipids, and the pressor response to an infusion of Intralipid and heparin were obtained. In contrast to previous reports concerning very low-salt diets, obese hypertensives did not manifest a pressor response or an adverse lipid effect with moderate salt restriction. Obese hypertensives were not more salt-sensitive than lean normotensives and did not manifest a different hemodynamic response to 4-hour infusion of Intralipid and heparin while on the 120-mmol/day salt diet. During the 60-mmol/day salt diet, however, plasma triglycerides increased more in obese than in lean volunteers during the Intralipid and heparin infusion (398+/-38 vs. 264+/-18 mg/dL; p<0.05), and there were greater increases in mean blood pressure (12+/-2 vs. 7+/-2 mm Hg; p<0.05) and systemic vascular resistance (111+/-38 vs. 225+/-44 dyne.sec.cm-5) as well as a larger decrease in small artery compliance (22.5+/-0.6 vs. 20.4+/-0.6 mL/mm Hg x 100; p<0.05). These data suggest that modest dietary sodium restriction in obese hypertensives does not adversely affect baseline blood pressure or lipids, but it does magnify their adverse lipid and hemodynamic response to fat loading.
饮食中限制钠对胰岛素、血脂和血压的影响一直存在争议。有证据表明，对极低盐饮食的短期不良影响在适度限制钠的情况下不会长期持续。在本研究中，对12名体重正常的血压正常者和10名肥胖高血压患者进行了为期3周的适度饮食钠限制（60和120 mmol钠）影响的测量。测量了血压、血浆脂质以及对输注英脱利匹特和肝素的升压反应。与之前关于极低盐饮食的报道相反，肥胖高血压患者在适度限制盐的情况下未表现出升压反应或不良脂质效应。肥胖高血压患者并不比体重正常的血压正常者对盐更敏感，并且在每日摄入120 mmol盐的饮食期间，对英脱利匹特和肝素进行4小时输注时，未表现出不同的血流动力学反应。然而，在每日摄入60 mmol盐的饮食期间，肥胖志愿者在输注英脱利匹特和肝素时血浆甘油三酯的升高幅度大于体重正常的志愿者（398±38 vs. 264±18 mg/dL；p<0.05），平均血压（12±2 vs. 7±2 mmHg；p<0.05）和全身血管阻力（111±38 vs. 225±44 dyne·sec·cm⁻⁵）升高幅度更大，小动脉顺应性下降幅度也更大（22.5±0.6 vs. 20.4±0.6 mL/mm Hg×100；p<0.05）。这些数据表明，肥胖高血压患者适度饮食限制钠不会对基线血压或血脂产生不利影响，但会放大他们对脂肪负荷的不良脂质和血流动力学反应。
