Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Chronobiol Int. 2012 Dec;29(10):1412-7. doi: 10.3109/07420528.2012.728663. Epub 2012 Nov 6.
Impaired renal sodium excretion causes sodium retention, which prevents the nocturnal dip in blood pressure (BP); thus, high BP persists until excess sodium is excreted. The authors defined "dipping time" (DT) as the duration until the nocturnal BP falls below 90% of the daytime average. Diuretic (e.g., hydrochlorothiazide [HCTZ]) and angiotensin receptor blocker (ARB) are able to eliminate sodium retention and restore the non-dipper BP rhythm. Reanalysis of two previous studies demonstrate that HCTZ and ARB shortened the DT. Shortening DT correlated directly with the increase in daytime urinary sodium excretion (Study 2). DT can be used as a preliminary indicator of sodium retention.
肾功能不全导致钠排泄减少，引起钠潴留，从而阻止夜间血压下降（BP）；因此，高血压持续存在，直到过量的钠被排出。作者将“下降时间”（DT）定义为夜间 BP 下降到白天平均水平的 90%以下的持续时间。利尿剂（如氢氯噻嗪[HCTZ]）和血管紧张素受体阻滞剂（ARB）能够消除钠潴留，恢复非杓型血压节律。对两项先前研究的重新分析表明，HCTZ 和 ARB 缩短了 DT。DT 的缩短与白天尿钠排泄的增加呈直接相关（研究 2）。DT 可作为钠潴留的初步指标。
