Tobian L
University of Minnesota Hospital, Minneapolis 55455.
J Hypertens Suppl. 1988 Dec;6(4):S12-24. doi: 10.1097/00004872-198812040-00003.
For the first 98.5% of mankind's existence, prehistoric people all ate low-sodium high-potassium, low-fat diets. With evolutionary forces working all this while, humans became very well adapted to the low-sodium, high-potassium, low-fat diet. In modern times, man has deserted his ancient cuisine and now favours a high-sodium, low-potassium, high-fat diet, which has produced several 'diseases of civilization', including hypertension. Many studies indicate that a 'normal'-potassium diet encourages arterial thickening and lesions in hypertensive arteries and kidneys, whereas a high-potassium diet can prevent many of these arterial and renal lesions, even though the blood pressure remains equally hypertensive. The high-potassium diet also tends to retard the development of hypertension. In susceptible people and rats, a high-NaCl diet leads to hypertension. This susceptibility is probably brought about by kidneys that have a sluggish sodium excretion in response to a NaCl load. This type of kidney combined with a high-NaCl diet tends to produce NaCl retention. Evidence is presented that this NaCl signal may be perceived by structures in the wall of the third brain ventricle. In susceptible men or rats, this can lead to a hypertensive rise in blood pressure, which over time can become partially irreversible, even though a low-NaCl diet is reinstituted.
在人类存在的最初98.5%的时间里，史前人类都食用低钠高钾、低脂肪的饮食。在这一时期进化力量一直在起作用，人类变得非常适应低钠、高钾、低脂肪的饮食。在现代，人类抛弃了古老的烹饪方式，如今偏爱高钠、低钾、高脂肪的饮食，这引发了多种“文明病”，包括高血压。许多研究表明，“正常”钾含量的饮食会促使高血压患者的动脉增厚以及动脉和肾脏出现病变，而高钾饮食可以预防许多这类动脉和肾脏病变，即便血压仍处于高血压水平。高钾饮食还往往会延缓高血压的发展。在易感人群和大鼠中，高氯化钠饮食会导致高血压。这种易感性可能是由肾脏对氯化钠负荷的钠排泄迟缓所致。这种类型的肾脏与高氯化钠饮食相结合往往会导致氯化钠潴留。有证据表明，这种氯化钠信号可能被第三脑室壁中的结构感知到。在易感男性或大鼠中，这会导致血压出现高血压性升高，随着时间的推移，即使恢复低氯化钠饮食，这种升高也可能会部分变得不可逆。
