Department of Neurosurgery, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima 770-8503, Japan.
Hypertension. 2012 Nov;60(5):1309-15. doi: 10.1161/HYPERTENSIONAHA.112.198762. Epub 2012 Oct 8.
The incidence of cerebral aneurysms is higher in women than in men, especially postmenopause. Although hypertension is thought to be associated with a high incidence of stroke, not all patients with unruptured cerebral aneurysms are hypertensive. The possibility of water-free Na(+) storage associated with hypertension has been raised. However, whether the increase in the body Na(+)/water ratio that characterizes water-free Na(+) accumulation is associated with the formation of cerebral aneurysms remains obscure. To examine this relationship, Sprague-Dawley female rats subjected to carotid artery ligation were divided into 3 groups: a high-salt diet group (HSD) without and another with bilateral oophorectomy (HSD/OVX) and a third group that underwent additional renal artery ligation (HSD/OVX/RL). Compared with rats receiving a normal diet (shams), water retention was increased in HSD rats but not in HSD/OVX rats. Interestingly, compared with HSD rats, the incidence of cerebral aneurysms and the body Na(+)/water ratio were significantly higher in HSD/OVX and HSD/OVX/RL rats, independent of hypertension. In their aneurysmal wall, ATP1α2, a subtype of Na(+)/K(+)-ATPase, was downregulated, whereas inflammatory-related molecules were upregulated. Treatment with low-dose olmesartan that did not affect the blood pressure in hypertensive HSD/OVX/RL rats reduced the rate of cerebral aneurysm formation, body Na(+) retention, and the Na(+)/water ratio and upregulated ATP1α2. These results suggest that the increase in the Na(+)/water ratio and a reduction in ATP1α2 may be associated with cerebral aneurysm formation. We provide the new insight that the management of water-free Na(+) is important to prevent their development.
女性脑动脉瘤的发病率高于男性,尤其是绝经后。虽然高血压被认为与中风的高发病率有关,但并非所有未破裂脑动脉瘤患者都患有高血压。与高血压相关的无水 Na(+) 储存的可能性已经提出。然而,与无水 Na(+) 积累相关的体 Na(+)/水比值的增加是否与脑动脉瘤的形成有关仍不清楚。为了研究这种关系,将接受颈动脉结扎的 Sprague-Dawley 雌性大鼠分为 3 组:高盐饮食组(HSD)无卵巢切除术和另一种双侧卵巢切除术(HSD/OVX)和第三组接受额外的肾动脉结扎(HSD/OVX/RL)。与接受正常饮食(假手术)的大鼠相比,HSD 大鼠的水潴留增加,但 HSD/OVX 大鼠的水潴留没有增加。有趣的是,与 HSD 大鼠相比,HSD/OVX 和 HSD/OVX/RL 大鼠的脑动脉瘤发生率和体 Na(+)/水比值明显更高,与高血压无关。在其动脉瘤壁中,Na(+)/K(+)-ATPase 的一种亚型 ATP1α2 下调,而炎症相关分子上调。用不影响高血压 HSD/OVX/RL 大鼠血压的低剂量奥美沙坦治疗可降低脑动脉瘤形成率、体 Na(+) 潴留率和 Na(+)/水比值,并上调 ATP1α2。这些结果表明,Na(+)/水比值的增加和 ATP1α2 的减少可能与脑动脉瘤的形成有关。我们提供了新的见解,即无水 Na(+) 的管理对于预防其发展很重要。