Schulman Ivonne Hernandez, Aranda Pedro, Raij Leopoldo, Veronesi Maddalena, Aranda Francisco J, Martin Remedios
Veterans Affairs Medical Center, Division of Nephrology, Hypertension and Vascular Biology Institute, University of Miami Miller School of Medicine, FL, USA.
Hypertension. 2006 Jun;47(6):1168-74. doi: 10.1161/01.HYP.0000218857.67880.75. Epub 2006 Apr 17.
Salt sensitivity of blood pressure is associated with an elevated risk of developing hypertension (HTN) and is an independent risk factor for cardiovascular disease. The prevalence of HTN increases after menopause. The aim of this study was to investigate prospectively whether the loss of ovarian hormones increases the occurrence of salt sensitivity among healthy premenopausal women. We enrolled 40 normotensive, nondiabetic women (age 47.2+/-3.5), undergoing hysterectomy-oophorectomy for nonneoplastic processes and not on hormone replacement, to determine the effect of changes in sodium intake on blood pressure the day before and subsequently 4 months after surgical menopause. Salt loading was achieved using a 2-L normal saline infusion and salt depletion produced by 40 mg of intravenous furosemide. A decrease >10 mm Hg in systolic blood pressure between salt loading and salt depletion was used to define salt sensitivity. Before and after menopause, salt-sensitive women exhibited higher waist/hip and waist/thigh ratios (P<0.01). Although all of the women remained normotensive, the prevalence of salt sensitivity was significantly higher after surgical menopause (21 women; 52.5%) than before (9 women; 22.5%; P=0.01), because 12 (38.7%) salt-resistant women developed salt sensitivity after menopause. In summary, we demonstrated that the prevalence of salt sensitivity doubled as early as 4 months after surgical menopause, without an associated increase in blood pressure. Epidemiological studies indicate that development of HTN may not occur until 5 to 10 years after menopause. The loss of ovarian hormones may unmask a population of women prone to salt sensitivity who, with aging, would be at higher risk for the subsequent development of HTN and cardiovascular disease.
血压盐敏感性与高血压（HTN）发生风险升高相关，是心血管疾病的独立危险因素。绝经后高血压患病率增加。本研究的目的是前瞻性调查卵巢激素丧失是否会增加健康绝经前女性盐敏感性的发生。我们纳入了40名血压正常、无糖尿病的女性（年龄47.2±3.5岁），她们因非肿瘤性疾病接受子宫切除-卵巢切除术且未接受激素替代治疗，以确定手术绝经前一天及术后4个月钠摄入量变化对血压的影响。通过输注2升生理盐水实现盐负荷，通过静脉注射40毫克速尿实现盐耗竭。盐负荷和盐耗竭之间收缩压下降>10毫米汞柱被用于定义盐敏感性。绝经前后，盐敏感女性的腰臀比和腰大腿比更高（P<0.01）。尽管所有女性血压仍正常，但手术绝经后盐敏感性患病率（21名女性；52.5%）显著高于绝经前（9名女性；22.5%；P=0.01），因为12名（38.7%）盐抵抗女性在绝经后出现了盐敏感性。总之，我们证明手术绝经后仅4个月盐敏感性患病率就增加了一倍，且血压无相关升高。流行病学研究表明，高血压可能直到绝经后5至10年才会发生。卵巢激素丧失可能会揭示出一群易患盐敏感性的女性，随着年龄增长，她们随后发生高血压和心血管疾病的风险会更高。
