Lind L, Wengle B, Wide L, Ljunghall S
Department of Internal Medicine, Gävle County Hospital, Uppsala, Sweden.
Am J Hypertens. 1989 Jan;2(1):20-5. doi: 10.1093/ajh/2.1.20.
Patients with essential hypertension, in particular those with low plasma renin activity (PRA), are reported to have lowered plasma-ionized calcium and elevated parathyroid hormone levels. In this study 1 microgram alphacalcidol (1 alpha-hydroxy-vitamin D3) was given in a double-blind, placebo-controlled fashion over four months to 39 subjects with mild to moderate hypertension. There was a significant rise in PRA in the treatment group when compared to placebo (P less than .05), but the mean blood pressure response was similar in the two groups. When the treatment group was divided according to pretreatment PRA it was, however, seen that subjects with low PRA displayed a reduction in diastolic blood pressure, whereas those with high PRA raised their blood pressure compared to placebo. Also subjects with low pretreatment values for plasma-ionized calcium and high levels of parathyroid hormone showed a reduction in diastolic blood pressure. This study supports the idea of a relationship between calcium metabolism and the renin-aldosterone system in essential hypertension and describes a beneficial effect of vitamin D supplementation on blood pressure in low-renin hypertension.
据报道，原发性高血压患者，尤其是血浆肾素活性（PRA）较低的患者，其血浆离子钙水平降低，甲状旁腺激素水平升高。在本研究中，以双盲、安慰剂对照的方式，对39名轻至中度高血压患者给予1微克阿法骨化醇（1α-羟基维生素D3），为期四个月。与安慰剂组相比，治疗组的PRA显著升高（P<0.05），但两组的平均血压反应相似。然而，当根据治疗前的PRA对治疗组进行划分时，发现PRA较低的受试者舒张压降低，而PRA较高的受试者与安慰剂组相比血压升高。此外，血浆离子钙治疗前值较低且甲状旁腺激素水平较高的受试者舒张压也降低。本研究支持原发性高血压中钙代谢与肾素-醛固酮系统之间存在关联的观点，并描述了补充维生素D对低肾素性高血压血压的有益作用。
