Wambach G, Helber A, Bönner G, Konrads A, Hummerich W, Meurer K A, Kaufmann W
Clin Exp Hypertens A. 1982;4(9-10):1835-49. doi: 10.3109/10641968209061644.
The pattern of aldosterone excretion during high sodium intake in 100 patients with essential hypertension allowed the differentiation of two groups: in the majority of patients (group A, n = 64) aldosterone excretion was suppressed below 6 micrograms/day similar to the normotensive control group. In a second group (group B, n = 36), aldosterone remained above the control range despite forced sodium loading. In group B, serum potassium was significantly lower than in patients of group A (3.81 +/- 0.44 meq/l vs. 4.26 +/- 0.57 meq/l, p less than 0.001). The blood pressure lowering effect of spironolactone (200 mg/d) was more pronounced among patients in group B. Plasma renin values tended to be lower in group B compared to patients with suppressed aldosterone. Infusion of Angiotensin II (0.1 - 2 micrograms/kg/min) led to a similar relative rise of plasma aldosterone levels in both groups despite higher baseline values in group B. The exact mechanism of the impaired regulation of aldosterone in a subgroup of patients with essential hypertension remains to be elucidated.
对100例原发性高血压患者高钠摄入期间的醛固酮排泄模式进行分析，可将其分为两组：大多数患者（A组，n = 64）的醛固酮排泄被抑制至6微克/天以下，与血压正常的对照组相似。在第二组（B组，n = 36）中，尽管强制摄入钠，醛固酮水平仍高于对照组范围。B组患者的血清钾显著低于A组患者（3.81±0.44毫当量/升对4.26±0.57毫当量/升，p<0.001）。螺内酯（200毫克/天）对B组患者的降压作用更为明显。与醛固酮被抑制的患者相比，B组患者的血浆肾素值往往较低。尽管B组的基线值较高，但输注血管紧张素II（0.1 - 2微克/千克/分钟）导致两组患者的血浆醛固酮水平出现相似的相对升高。原发性高血压患者亚组中醛固酮调节受损的确切机制仍有待阐明。
