From the Department of Physiology and Biophysics (D.A.H., T.E.L.) and Department of Surgery (D.A.H.), University of Mississippi Medical Center, Jackson; North Memorial Medical Center, Trauma Services, Robbinsdale, MN (E.D.I.); and CVRx, Inc, Minneapolis, MN (A.W.C.).
Hypertension. 2014 Sep;64(3):604-9. doi: 10.1161/HYPERTENSIONAHA.114.03788. Epub 2014 Jun 16.
Chronic electric activation of the carotid baroreflex produces sustained reductions in sympathetic activity and arterial pressure and is currently being evaluated as antihypertensive therapy for patients with resistant hypertension. However, the influence of variations in salt intake on blood pressure lowering during baroreflex activation (BA) has not yet been determined. As the sensitivity of arterial pressure to salt intake is linked to the responsiveness of renin secretion, we determined steady-state levels of arterial pressure and neurohormonal responses in 6 dogs on low, normal, and high salt intakes (5, 40, 450 mmol/d, respectively) under control conditions and during a 7-day constant level of BA. Under control conditions, there was no difference in mean arterial pressure at low (92±1) and normal (92±2 mm Hg) sodium intakes, but pressure increased 9±2 mm Hg during high salt. Plasma renin activity (2.01±0.23, 0.93±0.20, 0.01±0.01 ng angiotensin I/mL/h) and plasma aldosterone (10.3±1.9, 3.5±0.5, 1.7±0.1 ng/dL) were inversely related to salt intake, whereas there were no changes in plasma norepinephrine. Although mean arterial pressure (19-22 mm Hg) and norepinephrine (20%-40%) were lower at all salt intakes during BA, neither the changes in pressure nor the absolute values for plasma renin activity or aldosterone in response to salt were different from control conditions. These findings demonstrate that suppression of sympathetic activity by BA lowers arterial pressure without increasing renin release and indicate that changes in sympathetic activity are not primary mediators of the effect of salt on renin secretion. Consequently, blood pressure lowering during BA is independent of salt intake.
慢性电刺激颈动脉压力感受器会持续降低交感神经活动和动脉血压,目前正在评估其作为抗高血压治疗抵抗性高血压患者的疗效。然而,盐摄入量变化对压力感受器激活(BA)期间血压降低的影响尚未确定。由于动脉血压对盐摄入量的敏感性与肾素分泌的反应性有关,我们在 6 只狗中确定了低、正常和高盐摄入量(分别为 5、40 和 450mmol/d)下的动脉血压和神经激素反应的稳态水平,以及在 7 天的 BA 恒定水平下的情况。在对照条件下,低(92±1)和正常(92±2mmHg)钠摄入时平均动脉压没有差异,但高盐时血压升高 9±2mmHg。血浆肾素活性(2.01±0.23、0.93±0.20、0.01±0.01ng 血管紧张素 I/mL/h)和血浆醛固酮(10.3±1.9、3.5±0.5、1.7±0.1ng/dL)与盐摄入量呈负相关,而血浆去甲肾上腺素没有变化。尽管在 BA 期间所有盐摄入量下平均动脉压(19-22mmHg)和去甲肾上腺素(20%-40%)均较低,但压力变化以及盐反应中血浆肾素活性或醛固酮的绝对值与对照条件均无差异。这些发现表明,BA 抑制交感神经活动会降低动脉血压而不会增加肾素释放,并表明交感神经活动的变化不是盐对肾素分泌影响的主要介导因素。因此,BA 期间的血压降低与盐摄入量无关。