Del Río A, Rodríguez-Villamil J L, López-Campos J M, Carrera F
Unidad de Hipertensión, I.M.Q. San Rafael.
Rev Clin Esp. 1990 Jan;186(1):5-10.
Moderate salt restriction is of debatable efficacy in the treatment of mild or moderate hypertension; however, salt restriction enhances the activity of most antihypertensive drugs. Some observations suggest that the antihypertensive activity of calcium antagonists is not increased or could even decrease with dietary salt restriction. In the present work 15 patients suffering arterial hypertension and normal renal function are studied during four two week periods; a) unrestricted diet and medication, b) unrestricted diet and nifedipine (40 mg/day), c) low salt diet (5 g of salt/day) and nifedipine, and d) the same low salt diet, nifedipine and a salt supplement (6 g/day); salt or placebo were given in a double blind manner. At the end of each period arterial blood pressure was recorded, a urine sample for sodium determination was taken, and a blood sample was drawn for serum renine activity and biochemical parameters; at the end of each period patients' weight was recorded. Blood pressure significantly decreased (systolic: 9.83%, and dyastolic 11.17%) in patients treated with nifedipine, with no differences observed with salt modifications. Urinary sodium reflected correctly dietary salt modifications. Serum renine activity significantly increased during salt restriction. No significant changes were observed in weight or in the biochemical parameters studied. These results seem to suggest that the antihypertensive effect of nifedipine in patents suffering mild to moderate essential hypertension, with no change observed is not altered by the amount of salt in diet, at least within the limits studied (89.7 to 190 mEq/day of Sodium).
适度限制盐摄入对治疗轻度或中度高血压的疗效存在争议;然而,限制盐摄入可增强大多数抗高血压药物的活性。一些观察结果表明,钙拮抗剂的抗高血压活性不会因饮食中盐的限制而增加,甚至可能降低。在本研究中,对15名患有动脉高血压且肾功能正常的患者进行了为期四个两周的研究:a)无盐限制饮食并服用药物,b)无盐限制饮食并服用硝苯地平(40毫克/天),c)低盐饮食(5克盐/天)并服用硝苯地平,d)相同的低盐饮食、硝苯地平并补充盐分(6克/天);以双盲方式给予盐或安慰剂。在每个阶段结束时,记录动脉血压,采集尿液样本测定钠含量,采集血液样本测定血清肾素活性和生化参数;在每个阶段结束时记录患者体重。服用硝苯地平的患者血压显著下降(收缩压:9.83%,舒张压:11.17%),盐摄入改变未观察到差异。尿钠正确反映了饮食中盐的改变。限制盐摄入期间血清肾素活性显著增加。体重或所研究的生化参数未观察到显著变化。这些结果似乎表明,硝苯地平对轻度至中度原发性高血压患者的降压作用不受饮食中盐量的影响,至少在所研究的范围内(钠89.7至190毫当量/天)没有变化。