Hypertension Section.
Department of Internal Medicine.
Curr Opin Nephrol Hypertens. 2019 Jul;28(4):345-351. doi: 10.1097/MNH.0000000000000503.
The purpose of this study is to review the current literature related to the role of inorganic phosphate in the pathogenesis of hypertension.
An increasing number of publications have revealed a detrimental role of inorganic phosphate, which is commonly used as a flavor enhancer or preservative in the processed food, in promoting hypertension in otherwise healthy individuals. Animal experimental data indicate that dietary phosphate excess engages multiple mechanisms that promote hypertension, including overactivation of the sympathetic nervous system, increased vascular stiffness, impaired endothelium-dependent vasodilation, as well as increased renal sodium absorption or renal injury. These effects may be explained by direct effects of high extracellular phosphate levels or increase in phosphaturic hormones such as fibroblast growth factor 23, or downregulation of klotho, a transmembrane protein expressed in multiple organs which possess antiaging property.
Dietary phosphate, particularly inorganic phosphate, is an emerging risk factor for hypertension which is ubiquitous in the western diet. Large randomized clinical trials are needed to determine if lowering dietary phosphate content constitutes an effective nonpharmacologic intervention for prevention and treatment of hypertension.
本研究旨在综述目前有关无机磷酸盐在高血压发病机制中作用的文献。
越来越多的研究揭示了无机磷酸盐（通常作为加工食品中的增味剂或防腐剂）在促进健康人群高血压方面的有害作用。动物实验数据表明，饮食磷酸盐过量通过多种机制促进高血压，包括交感神经系统过度激活、血管僵硬增加、内皮依赖性血管舒张受损以及肾钠吸收增加或肾损伤。这些作用可能归因于细胞外高磷酸盐水平的直接作用或成纤维细胞生长因子 23 等排磷酸盐激素的增加，或跨膜蛋白 klotho 的下调，klotho 表达于多个具有抗衰老特性的器官。
饮食磷酸盐，尤其是无机磷酸盐，是一种普遍存在于西方饮食中的高血压新兴危险因素。需要进行大型随机临床试验来确定降低饮食磷酸盐含量是否构成预防和治疗高血压的有效非药物干预措施。
