Del Río A, Rodríguez-Villamil J L
IMQ San Rafael, La Coruña, Department of Medicine, Faculty of Medicine, Santiago University, Santiago de Compostela, Spain.
J Intern Med. 1993 May;233(5):409-14. doi: 10.1111/j.1365-2796.1993.tb00692.x.
Some observations suggest that a strict low-salt diet may induce unfavourable metabolic side-effects. The main aim of this study was to analyse the possible consequences of severe salt restriction in mildly hypertensive patients.
The study was carried out through a randomized double-blind protocol.
Forty-seven ambulatory patients proceeding from the hypertension unit were initially admitted: 17 were lost, and 30 non-diabetic mildly hypertensives (DBP 90-104 mmHg) with normal renal function completed the protocol.
After a wash-out period, patients were maintained on a low-salt intake (2.8 +/- 1.0 g day-1 of NaCl) and placebo for 2 weeks, and the same diet and salt supplements (11.7 +/- 2.5 g day-1 of NaCl) for another 2 weeks, separated by a second wash-out period.
At the end of each dietary period, blood pressure (BP) and body weight were measured, and a blood sample was taken for determination of routine serum chemistries, plasma lipid and apolipoprotein concentrations, immunoreactive insulin (IRI), and plasma renin activity (PRA). Urinary 24 h excretion of sodium and potassium were measured.
During the salt restriction period BP did not change, weight lowered, and PRA raised. There was a significant increase in serum level of creatinine, uric acid, IRI, total cholesterol and apo B, and a decrease in HDL cholesterol and apo A-I.
As previously suggested, these observations seem to indicate that strict salt restriction may cause, at least in the short-term, adverse metabolic changes in hypertensive patients.
一些观察结果表明，严格的低盐饮食可能会引发不良的代谢副作用。本研究的主要目的是分析严重限盐对轻度高血压患者可能产生的后果。
本研究通过随机双盲方案进行。
最初纳入了47名来自高血压科的门诊患者：17名失访，30名肾功能正常的非糖尿病轻度高血压患者（舒张压90 - 104 mmHg）完成了研究方案。
在洗脱期后，患者先维持低盐摄入（氯化钠2.8 ± 1.0 g/天）并服用安慰剂2周，然后在另一个2周内维持相同饮食并补充盐分（氯化钠11.7 ± 2.5 g/天），中间间隔第二个洗脱期。
在每个饮食阶段结束时，测量血压（BP）和体重，并采集血样以测定常规血清化学指标、血浆脂质和载脂蛋白浓度、免疫反应性胰岛素（IRI）以及血浆肾素活性（PRA）。测量24小时尿钠和尿钾排泄量。
在限盐期间，血压未变化，体重下降，PRA升高。血清肌酐、尿酸、IRI、总胆固醇和载脂蛋白B水平显著升高，高密度脂蛋白胆固醇和载脂蛋白A-I降低。
如先前所述，这些观察结果似乎表明，严格限盐至少在短期内可能会导致高血压患者出现不良的代谢变化。
