Luft F C, Weinberger M H, Grim C E, Fineberg N S
J Hypertens Suppl. 1986 Dec;4(5):S198-201.
We analysed the blood pressure, natriuretic and hormonal responses of 378 normal volunteers and 198 essential hypertensives after an intravenous infusion of 2 litres of isotonic saline and after a low-sodium diet and furosemide. Those in whom mean arterial blood pressure decreased by greater than 10 mmHg after sodium and volume depletion were considered sodium-sensitive, and those in whom a decrease of less than 5 mmHg was observed were considered sodium-resistant. Sodium-sensitive individuals had lower renin values than those who were resistant to sodium. Both normal and hypertensive sodium-sensitive individuals exhibited an 'exaggerated' natriuresis compared with resistant subjects. Sodium-sensitive subjects exhibited greater aldosterone responses to renin stimulation after volume depletion than resistant subjects. Sodium sensitivity is associated with exaggerated natriuresis as well as tighter coupling between renin and aldosterone. Relative volume expansion could account for the differences observed between sensitive and resistant individuals.
我们分析了378名正常志愿者和198名原发性高血压患者在静脉输注2升等渗盐水后，以及在低钠饮食和使用速尿后的血压、利钠和激素反应。钠和容量耗竭后平均动脉血压下降超过10 mmHg的个体被认为是钠敏感型，而观察到下降小于5 mmHg的个体被认为是钠抵抗型。钠敏感个体的肾素值低于钠抵抗个体。与抵抗个体相比，正常和高血压钠敏感个体均表现出“过度”的利钠作用。钠敏感个体在容量耗竭后对肾素刺激的醛固酮反应比抵抗个体更大。钠敏感性与过度利钠以及肾素和醛固酮之间更紧密的耦合有关。相对容量扩张可以解释敏感个体和抵抗个体之间观察到的差异。
