Ernst F A, Enwonwu C O, Francis R A
Department of Family and Preventive Medicine, Meharry Medical College, Nashville, Tennessee 37208.
Am J Hypertens. 1990 Jun;3(6 Pt 1):451-7. doi: 10.1093/ajh/3.6.451.
The roles of dietary and behavioral factors in the etiology of hypertension are not well understood. Vulnerability to hypertension is thought to be affected by a complex interaction of nutritional, genetic, neurophysiological, and psychosocial influences. We studied cardiovascular reactivity to sodium and stress in a group of 29 normotensive young men who were vulnerable to hypertension by virtue of familial and/or racial factors. Subjects with positive and negative parental histories of hypertension were provided all meals for five days during which blood pressure was monitored before each meal. Two groups were given 300 mEq/day dietary sodium with either 1100 mg/day or 410 mg/day dietary calcium. A third group consumed a 10mEq sodium diet with low dietary calcium. On the fifth day of the diet all subjects were tested for cardiovascular reactivity using a modified Stroop test as a mentally challenging task. Adaptation of systolic blood pressure (SBP) from the first to the fifth breakfast was most pronounced in subjects consuming high calcium with high sodium. Perseveration of SBP reactivity to repeated mental challenge was found in subjects who consumed high sodium with low calcium and in subjects with positive parental histories of hypertension. The perseverative phenomenon was particularly well-defined in subjects who had the highest urinary excretion of calcium. Our findings suggest a prophylactic influence of dietary calcium and its retention on cardiovascular reactivity to sodium and stress. We also elucidate a theoretical proposition concerning the role of neurophysiological inhibitory capacity in the transition from normotension to the chronic dysregulatory state of essential hypertension.
饮食和行为因素在高血压病因中的作用尚未得到充分理解。人们认为，高血压易感性受营养、遗传、神经生理和社会心理等多种影响因素的复杂相互作用所左右。我们对一组29名血压正常的年轻男性进行了研究，这些男性由于家族和/或种族因素而易患高血压。有高血压家族史阳性和阴性的受试者连续五天提供所有餐食，在此期间，每餐饭前监测血压。两组分别给予每日300毫当量膳食钠，膳食钙分别为每日1100毫克或410毫克。第三组食用含10毫当量钠且膳食钙含量低的饮食。在饮食的第五天，所有受试者都使用改良的斯特鲁普测试作为一项具有心理挑战性的任务来测试心血管反应性。在摄入高钙高钠的受试者中，从第一顿早餐到第五顿早餐收缩压（SBP）的适应性最为明显。在摄入高钠低钙的受试者以及有高血压家族史阳性的受试者中，发现SBP对重复心理挑战的反应具有持续性。在钙尿排泄量最高的受试者中，这种持续性现象尤为明显。我们的研究结果表明，膳食钙及其潴留对心血管对钠和应激的反应具有预防作用。我们还阐明了一个关于神经生理抑制能力在从正常血压转变为原发性高血压慢性调节异常状态过程中作用的理论命题。
