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[原发性高血压患者的适度补钾]

[Moderate supplementation of potassium in essential hypertension].

作者信息

MacGregor G A, Smith S J, Markandu N D, Banks R A, Sagnella G A

出版信息

Arch Mal Coeur Vaiss. 1984 Apr;77 Spec No:93-100.

PMID:6428368
Abstract

23 unselected patients with mild to moderate essential hypertension, whose average supine blood pressure after two months' observation on no treatment was 154/99 mm Hg, were entered into an eight week double blind randomised crossover study of one month's treatment with slow release potassium tablets (60 mmol/day) versus placebo without alteration of dietary sodium or potassium intake. By the fourth week mean supine blood pressure had fallen by 4% on potassium supplementation compared with placebo. Urinary potassium excretion increased from 62 +/- 4.7 mmol/24 h on placebo to 118 +/- 7.4 mmol/24 h on potassium. The fall in blood pressure was not related to urinary sodium excretion before entry to the trial or while on placebo. Moderate potassium supplementation caused a small but significant fall in blood pressure in patients with mild to moderate essential hypertension and could be additive to the effects of moderate sodium restriction. This increase in potassium intake could be achieved with a potassium-based salt substitute and a moderate increase in vegetable and fruit consumption. Moderate dietary sodium restriction with dietary potassium supplementation may obviate or reduce the need for drug treatment in some patients with mild to moderate hypertension.

摘要

23例未经挑选的轻至中度原发性高血压患者,在未接受治疗观察两个月后,其平均仰卧血压为154/99 mmHg,进入一项为期8周的双盲随机交叉研究,比较服用缓释钾片(60 mmol/天)治疗1个月与服用安慰剂的效果,期间饮食中钠和钾的摄入量不变。到第4周时,与安慰剂相比,补充钾后平均仰卧血压下降了4%。尿钾排泄量从服用安慰剂时的62±4.7 mmol/24小时增加到服用钾时的118±7.4 mmol/24小时。血压下降与试验开始前或服用安慰剂期间的尿钠排泄无关。适度补充钾可使轻至中度原发性高血压患者的血压出现小幅但显著的下降,并且可能与适度限制钠的作用相加。增加钾的摄入量可以通过使用含钾盐替代品以及适度增加蔬菜和水果的摄入量来实现。适度限制饮食中的钠并补充饮食中的钾,可能会使一些轻至中度高血压患者无需或减少药物治疗的需求。

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