Kimura G, Deguchi F, Kojima S, Ashida T, Yoshimi H, Abe H, Kawano Y, Yoshida K, Imanishi M, Kawamura M
Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Am J Hypertens. 1988 Oct;1(4 Pt 1):372-9. doi: 10.1093/ajh/1.4.372.
The hypotensive effects of some antihypertensive drugs are augmented under sodium restriction, while those of others are not. The mechanisms of these interactions were theoretically analyzed based on the arterial pressure-natriuresis relationship. Four-week studies were performed in 24 patients with essential hypertension who were given a regular sodium diet (12-15 g of NaCl/d) in the first and third weeks and a sodium-restricted diet (1-3 g/d) in the second and fourth weeks. One of three antihypertensive drugs, 60 mg/d of nicardipine (Ca-antagonist), 120 mg/d of propranolol (beta-blocker) or 150 mg/d of captopril (converting-enzyme inhibitor) was administered in the third and fourth weeks. The mean arterial pressure and urinary sodium excretion were measured on the last three days of each week. The degree of interaction between the antihypertensive drugs and sodium restriction was statistically compared. The hypotensive effect of nicardipine and propranolol did not differ with the change in sodium intake, whereas that of captopril was greater under sodium restriction than under the regular sodium diet. Urinary sodium excretion was plotted on the ordinate as a function of arterial pressure before and after administration of the antihypertensive drugs. The pressure-natriuresis curve was shifted left, without a change in the slope, by nicardipine and propranolol and also left, but with a decrease in the slope, by captopril. The hypotensive effect of nicardipine and propranolol, being independent of the amount of sodium intake, was based on the leftward shift of the pressure-natriuresis curve that was probably due to the decrease in renal vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)
一些抗高血压药物的降压作用在限钠情况下会增强，而另一些则不会。基于动脉血压-利钠关系，从理论上分析了这些相互作用的机制。对24例原发性高血压患者进行了为期四周的研究，在第一周和第三周给予常规钠饮食（12 - 15克氯化钠/天），在第二周和第四周给予限钠饮食（1 - 3克/天）。在第三周和第四周给予三种抗高血压药物之一，即尼卡地平60毫克/天（钙拮抗剂）、普萘洛尔120毫克/天（β受体阻滞剂）或卡托普利150毫克/天（转换酶抑制剂）。在每周的最后三天测量平均动脉压和尿钠排泄量。对抗高血压药物与限钠之间的相互作用程度进行了统计学比较。尼卡地平和普萘洛尔的降压作用不随钠摄入量的变化而不同，而卡托普利在限钠情况下的降压作用比常规钠饮食时更强。将抗高血压药物给药前后的尿钠排泄量作为动脉压的函数绘制在纵坐标上。尼卡地平和普萘洛尔使压力-利钠曲线向左移动，斜率不变，卡托普利也使曲线向左移动，但斜率降低。尼卡地平和普萘洛尔的降压作用与钠摄入量无关，其基础是压力-利钠曲线向左移动，这可能是由于肾血管阻力降低所致。（摘要截短至250字）
