MacGregor G A
Eur Heart J. 1987 May;8 Suppl B:3-8. doi: 10.1093/eurheartj/8.suppl_b.3.
Much circumstantial and some direct evidence links a high sodium, low potassium intake to the development of essential hypertension. However, studies to prove a definite causative relationship in man are unlikely to be done for the practical reason that they need to be carried out over a whole generation. Restriction of sodium intake does lower blood pressure in many hypertensive subjects. This fall appears to be mediated in part by a diminished renin response to the sodium restriction as blood pressure becomes more severe. Less substantive evidence also suggests that increasing potassium intake may lower blood pressure but this effect seems to be more apparent when both animals and man are on a high sodium intake. It would seem sensible, therefore, in the light of present knowledge, to advise communities that have a high sodium, low potassium diet they they may benefit from a reduction in sodium and an increase in potassium intake. Patients who are already known to have high blood pressure should be advised to reduce sodium intake along with other non-pharmacological advice. In some patients this will be sufficient to control the blood pressure. In others who may then require drug treatment, the blood pressure lowering effect of beta-blockers and converting enzyme inhibitors will be enhanced by the sodium restriction.
大量的间接证据以及一些直接证据表明，高钠低钾饮食与原发性高血压的发生有关。然而，出于实际原因，即需要对整整一代人进行研究，要在人类身上证明明确的因果关系的研究不太可能进行。限制钠的摄入量确实能使许多高血压患者的血压降低。随着血压升高，这种血压下降似乎部分是由肾素对钠限制的反应减弱所介导的。同样，较少的实质性证据也表明，增加钾的摄入量可能会降低血压，但当动物和人类都摄入高钠饮食时，这种效果似乎更明显。因此，根据目前的知识，向那些饮食中钠含量高、钾含量低的人群建议，减少钠的摄入量并增加钾的摄入量可能会有益，这似乎是明智的。对于已经患有高血压的患者，应建议他们减少钠的摄入量，并给予其他非药物治疗建议。在一些患者中，这足以控制血压。在其他可能需要药物治疗的患者中，限制钠的摄入会增强β受体阻滞剂和血管紧张素转换酶抑制剂的降压效果。
