Redón-Más J, Abellán-Alemán J, Aranda-Lara P, de la Figuera-von Wichmann M, Luque-Otero M, Rodicio-Díaz J L, Ruilope-Urioste L M, Velasco-Quintana J
Hospital de Sagunto, Valencia, Spain.
J Hypertens. 1993 Jun;11(6):665-71. doi: 10.1097/00004872-199306000-00011.
To define the influence of dietary salt intake on the antihypertensive effect of slow-release verapamil 240 mg once a day in a population with mild-to-moderate essential hypertension.
Parallel, randomized, multicentre study.
Patients were advised to follow a moderately low salt diet (Low-salt group). After a 2-week run-in period, those patients with 24-h urinary sodium excretion (UNa) < or = 120 mmol/day and a diastolic blood pressure (DBP) between 90 and 114 mmHg were randomly assigned to verapamil + Low-salt or verapamil + unrestricted-salt diet (High-salt group) for 28 days. Compliance with diets was defined as Low-salt UNa < or = 120 mmol/day and High-salt UNa > 120 mmol/day with UNa increased by > or = 60 mmol/day over the level attained at the end of the run-in period.
Significant reductions in mean systolic blood pressure (SBP) and DBP were found in both the Low-salt (n = 235) and High-salt (n = 183) groups. The therapeutic goal (DBP < 90 mmHg) was achieved in 38.3% of patients in the Low-salt and 44.8% of patients in the High-salt group. Office blood pressure results were confirmed by ambulatory 24-h blood pressure monitoring in a subsample of patients. Verapamil reduced mean blood pressure throughout the nycthemeral cycle without any significant difference between the two groups.
The restriction in sodium intake does not have an additive effect on the antihypertensive effect of the slow-channel calcium antagonist verapamil.
确定饮食中盐摄入量对轻度至中度原发性高血压患者每日一次服用240毫克缓释维拉帕米降压效果的影响。
平行、随机、多中心研究。
建议患者遵循适度低盐饮食（低盐组）。经过2周的导入期后，将24小时尿钠排泄量（UNa）≤120 mmol/天且舒张压（DBP）在90至114 mmHg之间的患者随机分为维拉帕米+低盐组或维拉帕米+无盐限制饮食组（高盐组），为期28天。饮食依从性定义为低盐组UNa≤120 mmol/天，高盐组UNa>120 mmol/天，且UNa较导入期末达到的水平增加≥60 mmol/天。
低盐组（n = 235）和高盐组（n = 183）的平均收缩压（SBP）和DBP均显著降低。低盐组38.3%的患者和高盐组44.8%的患者实现了治疗目标（DBP<90 mmHg）。在部分患者亚组中，通过动态24小时血压监测证实了诊室血压结果。维拉帕米在整个昼夜周期内均降低了平均血压，两组之间无显著差异。
钠摄入量的限制对慢通道钙拮抗剂维拉帕米的降压效果没有附加作用。
