Wang Hongyi, Wang Xue, Tian Yan, Yang Li, Han Xiaoxia, Wang Zhuo, Nie Xiaoyan, Sun Ningling
Department of Hypertension, People's Hospital, Peking University, Beijing, China.
Department of Pharmacy Administration and Clinical Pharmacy School of Pharmaceutical Sciences, Peking University, Beijing, China.
Medicine (Baltimore). 2025 Feb 14;104(7):e41463. doi: 10.1097/MD.0000000000041463.
This study investigated the relationship between rs4673 of the nicotinamide adenine dinucleotide phosphate oxidase p22PHOX gene and blood pressure (BP) response to acute salt loading in a Chinese population diagnosed with essential hypertension. An acute salt loading test was performed using 2 L of normal saline (NS) infused over 4 hours. BP and heart rate were recorded immediately after NS infusion and hourly for the next 3 hours. Data analysis was performed using the chi-squared test, Student t test, and multivariable regression. A total of 159 patients were analyzed, including 129 with the CC genotype, 29 with the CT genotype, and 1 with the TT genotype. Individuals carrying the T allele exhibited greater tolerance to BP increases caused by 2 L NS infusion. Specifically, the systolic blood pressure change for T carriers was 0.26 ± 9.72 mm Hg, compared to 6.82 ± 11.65 mm Hg for those with the CC genotype (P = .005). Diastolic blood pressure changes were -3.35 ± 7.52 mm Hg in T carriers versus 1.38 ± 7.62 mm Hg in CC genotype carriers (P = .003), and mean arterial pressure changes were -2.13 ± 7.85 mm Hg in T carriers compared to 3.19 ± 7.81 mm Hg in CC genotype carriers (P = .001). These significant differences persisted after adjusting for gender, age, smoking, drinking, and baseline BP. Interestingly, not all subjects experienced increased BP following NS loading; 86.82% in the CC group did, versus 66.67% of T allele carriers (P = .014). The findings suggest that individuals carrying the T allele are less likely to be salt-sensitive, as indicated by a diminished BP response to acute saline infusion. This contributes to the understanding of the genetic factors that influence salt sensitivity in essential hypertension.
本研究在中国确诊为原发性高血压的人群中，调查了烟酰胺腺嘌呤二核苷酸磷酸氧化酶p22PHOX基因的rs4673与急性盐负荷后血压（BP）反应之间的关系。使用2升生理盐水（NS）在4小时内静脉输注进行急性盐负荷试验。输注NS后立即记录血压和心率，并在接下来的3小时内每小时记录一次。使用卡方检验、学生t检验和多变量回归进行数据分析。共分析了159例患者，其中129例为CC基因型，29例为CT基因型，1例为TT基因型。携带T等位基因的个体对2升NS输注引起的血压升高表现出更大的耐受性。具体而言，T等位基因携带者的收缩压变化为0.26±9.72毫米汞柱，而CC基因型者为6.82±11.65毫米汞柱（P = 0.005）。T等位基因携带者的舒张压变化为-3.35±7.52毫米汞柱，而CC基因型携带者为1.38±7.62毫米汞柱（P = 0.003），T等位基因携带者的平均动脉压变化为-2.13±7.85毫米汞柱，而CC基因型携带者为3.19±7.81毫米汞柱（P = 0.001）。在调整性别、年龄、吸烟、饮酒和基线血压后，这些显著差异仍然存在。有趣的是，并非所有受试者在NS负荷后血压都会升高；CC组中86.82%的受试者血压升高，而T等位基因携带者中这一比例为66.67%（P = 0.014）。研究结果表明，携带T等位基因的个体对急性盐水输注的血压反应减弱，表明其盐敏感性较低。这有助于理解影响原发性高血压盐敏感性的遗传因素。
