Kurtz T W, Al-Bander H A, Morris R C
Department of Laboratory Medicine, University of California at San Francisco 94143-0126.
N Engl J Med. 1987 Oct 22;317(17):1043-8. doi: 10.1056/NEJM198710223171702.
We investigated whether the anionic component of an orally administered sodium salt can influence the salt's capacity to increase blood pressure. In five men with essential hypertension in whom blood pressure was normal with restriction of dietary sodium chloride to 10 mmol per day (0.23 g of sodium per day), oral administration of sodium chloride for seven days, 240 mmol per day (5.52 g of sodium per day), induced significant increases in systolic and diastolic blood pressures, of 16 +/- 2 and 8 +/- 2 mm Hg (mean +/- SEM), respectively (P less than 0.05). An equimolar amount of sodium given as sodium citrate induced no change in blood pressure. Replacing supplemental sodium chloride with an equimolar amount of sodium as sodium citrate abolished the increase in blood pressure induced by sodium chloride. Both salts induced substantial and comparable sodium retention, weight gain, and suppression of plasma renin activity and plasma aldosterone, but supplemental sodium chloride increased plasma volume and urinary excretion of calcium, whereas sodium citrate did not. These preliminary findings demonstrate that the anionic component of an orally administered sodium salt can influence the ability of that salt to increase blood pressure, possibly by determining whether the salt induces an increase in plasma volume. Our observations in a small group of men with salt-sensitive hypertension will require confirmation in larger numbers of patients of both sexes.
我们研究了口服钠盐的阴离子成分是否会影响该盐升高血压的能力。在五名原发性高血压男性患者中，他们在将每日膳食氯化钠摄入量限制为10 mmol（每日0.23 g钠）时血压正常，口服氯化钠七天，每日240 mmol（每日5.52 g钠），导致收缩压和舒张压分别显著升高16±2和8±2 mmHg（平均值±标准误）（P<0.05）。给予等摩尔量的柠檬酸钠钠时血压无变化。用等摩尔量的柠檬酸钠钠替代补充氯化钠可消除氯化钠引起的血压升高。两种盐都引起了大量且相当的钠潴留、体重增加以及血浆肾素活性和血浆醛固酮的抑制，但补充氯化钠增加了血浆容量和尿钙排泄，而柠檬酸钠钠则没有。这些初步发现表明，口服钠盐的阴离子成分可能通过决定该盐是否会引起血浆容量增加来影响其升高血压的能力。我们在一小群盐敏感性高血压男性中的观察结果需要在更多的男女患者中得到证实。
