Textor S C, Turner S T
Division of Hypertension, Mayo Clinic, Rochester, Minn 55905.
Hypertension. 1991 Jun;17(6 Pt 2):982-8. doi: 10.1161/01.hyp.17.6.982.
Studies of normotensive offspring of hypertensive parents offer the potential to identify inherited abnormalities that contribute to essential hypertension. We compared renal and systemic hemodynamic responses to saline infusion between normotensive sons of two hypertensive parents (SOHT) and sons of two normotensive parents (SONT) selected from the general population of Rochester, Minn. Hemodynamic measurements were performed after a week of low sodium intake (10 meq/day) and were repeated after a week of high sodium intake (200 meq/day). Despite being in the normotensive range, blood pressures in SOHT were higher than those in SONT during low sodium (124 +/- 3/85 +/- 3 versus 118 +/- 2/71 +/- 2 mm Hg, p less than 0.01) and high sodium (122 +/- 3/80 +/- 3 versus 112 +/- 2/70 +/- 2 mm Hg, p less than 0.05) conditions. Higher pressures in SOHT were associated with elevated systemic and renal vascular resistance. After a high sodium diet, renal vascular resistance in SOHT rose further during acute saline infusion, whereas systemic vascular resistance did not change. After a low sodium diet, this renal vasoconstrictor response to saline infusion in SOHT was not present, and renal vascular resistance fell to levels not different from SONT. Plasma renin activity, aldosterone, and atrial natriuretic peptide did not differ between SONT and SOHT. Circulating levels of norepinephrine were higher in SOHT. These data demonstrate a renal vasoconstrictor response to saline infusion in normotensive SOHT, which depends on prior sodium intake. This alteration in renal hemodynamics may represent an inherited abnormality related to the development of hypertension.
对高血压患者的血压正常的后代进行研究,有助于识别导致原发性高血压的遗传异常。我们比较了两组人群的血流动力学反应:一组是选自明尼苏达州罗切斯特市普通人群的双亲为高血压患者的血压正常的儿子(SOHT),另一组是双亲血压正常的儿子(SONT)。在低钠摄入(10 meq/天)一周后进行血流动力学测量,然后在高钠摄入(200 meq/天)一周后重复测量。尽管血压处于正常范围内,但在低钠(124±3/85±3与118±2/71±2 mmHg,p<0.01)和高钠(122±3/80±3与112±2/70±2 mmHg,p<0.05)条件下,SOHT的血压高于SONT。SOHT中较高的血压与全身和肾血管阻力升高有关。高钠饮食后,SOHT在急性盐水输注期间肾血管阻力进一步升高,而全身血管阻力没有变化。低钠饮食后,SOHT对盐水输注的这种肾血管收缩反应不存在,肾血管阻力降至与SONT无差异的水平。SONT和SOHT之间的血浆肾素活性、醛固酮和心钠素没有差异。SOHT中去甲肾上腺素的循环水平较高。这些数据表明,血压正常的SOHT对盐水输注有肾血管收缩反应,这取决于先前的钠摄入量。这种肾血流动力学的改变可能代表了一种与高血压发展相关的遗传异常。