Resnick L M
Am J Med. 1987 Jan 26;82(1B):16-26. doi: 10.1016/0002-9343(87)90267-1.
Calcium metabolism plays an important role in blood pressure homeostasis, although it remains unclear to what extent calcium contributes to or, alternatively, protects against clinical hypertension. To resolve this confusion, hypertensive subgroups were first defined by plasma renin activity, dietary salt sensitivity, sensitivity to calcium channel blockade, and calcium metabolic indices. Using these classification schemes, different patterns of calcium metabolism emerged, each predictive of divergent clinical responses. Patients with low plasma renin activity, low serum ionized calcium levels, and dietary salt sensitivity, such as black and elderly hypertensive patients, may preferentially benefit from calcium supplementation. It is postulated that calcium-regulating hormones and the renin-angiotensin-aldosterone system coordinately monitor dietary mineral intake, and transduce these environmental signals at the cellular level by altering cellular calcium uptake and disposition. Analysis of these hormonal systems is useful diagnostically in defining those patients who would most benefit from non-pharmacologic dietary forms of treatment.
钙代谢在血压稳态中起着重要作用，尽管钙在何种程度上导致或预防临床高血压尚不清楚。为了解决这一困惑，首先根据血浆肾素活性、饮食盐敏感性、对钙通道阻滞剂的敏感性和钙代谢指标对高血压亚组进行了定义。使用这些分类方案，出现了不同的钙代谢模式，每种模式都能预测不同的临床反应。血浆肾素活性低、血清离子钙水平低且对饮食盐敏感的患者，如黑人和老年高血压患者，可能优先从补钙中获益。据推测，钙调节激素和肾素-血管紧张素-醛固酮系统协同监测饮食矿物质摄入，并通过改变细胞钙摄取和分布在细胞水平上转导这些环境信号。对这些激素系统的分析有助于诊断哪些患者将从非药物饮食治疗形式中获益最大。
