Higashi Y, Oshima T, Ozono R, Nakano Y, Matsuura H, Kambe M, Kajiyama G
First Department of Internal Medicine, Hiroshima University School of Medicine, Minami-ku, Japan.
Hypertension. 1997 Aug;30(2 Pt 1):163-7. doi: 10.1161/01.hyp.30.2.163.
We investigated the effect of NaCl on the circadian blood pressure rhythm in patients with essential hypertension classified according to the presence or absence of salt sensitivity. We obtained 24-hour noninvasive ambulatory blood pressure measurements in 64 Japanese patients with mild to moderate essential hypertension who ate a low NaCl diet (50 mmol/d) for 1 week, followed by a high NaCl diet (340 mmol/d) for 1 week. Twenty-six patients whose mean blood pressure was increased more than 10% by NaCl loading were classified as salt sensitive. The remaining 38 patients were classified as salt resistant. The nocturnal decline in mean blood pressure was significantly smaller in salt-sensitive patients (8.3+/-1.0%) than in salt-resistant patients (11.5+/-0.9%) (P<.05) during a high NaCl diet but was similar in both groups during a low NaCl diet. There was no significant difference in the prevalence of the non-dipper pattern between groups on a low NaCl diet, but the prevalence of the non-dipper pattern was significantly higher in salt-sensitive patients than in salt-resistant patients on a high NaCl diet (0.57 versus 0.26, chi2=6.4; P=.02; odds ratio, 3.82). These findings suggest that the NaCl loading blunted the nocturnal decline in blood pressure in salt-sensitive patients but not in salt-resistant patients.
我们根据盐敏感性的有无，对原发性高血压患者进行分类，研究了氯化钠对其昼夜血压节律的影响。我们对64例轻度至中度原发性高血压日本患者进行了24小时无创动态血压测量，这些患者先食用低氯化钠饮食（50 mmol/d）1周，随后食用高氯化钠饮食（340 mmol/d）1周。26例平均血压因氯化钠负荷增加超过10%的患者被分类为盐敏感型。其余38例患者被分类为盐抵抗型。在高氯化钠饮食期间，盐敏感型患者平均血压的夜间下降幅度（8.3±1.0%）显著小于盐抵抗型患者（11.5±0.9%）（P<0.05），但在低氯化钠饮食期间，两组情况相似。在低氯化钠饮食时，两组间非勺型模式的患病率无显著差异，但在高氯化钠饮食时，盐敏感型患者的非勺型模式患病率显著高于盐抵抗型患者（0.57对0.26，χ2=6.4；P=0.02；优势比，3.82）。这些发现表明，氯化钠负荷使盐敏感型患者夜间血压下降幅度减弱，但对盐抵抗型患者无此影响。
