Garfinkle Michael A
Department of Medicine, University of Calgary, Calgary, AB, Canada.
J Am Soc Hypertens. 2017 Jun;11(6):385-391. doi: 10.1016/j.jash.2017.04.006. Epub 2017 Apr 14.
Essential hypertension is common and is associated with significant morbidity and mortality. However, questions remain as to the exact physiological mechanisms underlying this disease. First, we discuss how essential hypertension may be largely a result of a maladaptation to a high-salt diet and that high blood pressure, rather than being an inactive side effect of high salt intake, may be an adaptive mechanism to improve salt secretion. Next, we explain how any physiological state that reduces urinary sodium concentrating ability may increase an individual's risk for salt-induced hypertension. Finally, we conclude that natriuresis is a crucial criterion for effective long-term pharmacologic treatment of essential hypertension.
原发性高血压很常见，且与显著的发病率和死亡率相关。然而，关于这种疾病的确切生理机制仍存在疑问。首先，我们讨论原发性高血压可能在很大程度上是对高盐饮食适应不良的结果，并且高血压可能是一种改善盐分泌的适应性机制，而不是高盐摄入的非活性副作用。接下来，我们解释任何降低尿钠浓缩能力的生理状态如何可能增加个体患盐诱导性高血压的风险。最后，我们得出结论，利钠作用是原发性高血压有效长期药物治疗的关键标准。
