Preuss H G
Georgetown University Medical Center, Dept of Medicine (Nephrology Division), Washington, DC 20007, USA.
J Am Coll Nutr. 1997 Aug;16(4):296-305. doi: 10.1080/07315724.1997.10718690.
It is generally accepted that genetics play a significant role in the pathogenesis of hypertension. Since hypertension often follows kidney transplantation, candidate genes have been sought and found in the kidneys of rats and humans. One well-recognized, inherited influence on blood pressure (BP) occurs via abnormal renal sodium handling in vivo. Further, abnormal renal sodium handling is seen in isolated kidneys of genetically hypertensive rats. People who have a relative inability to handle a sodium load properly, and retain it inappropriately, often develop high BP and are referred to as "salt-sensitive". More than half of patients diagnosed with essential hypertension are salt-sensitive. In contrast to the deleterious effects associated with high sodium intake, many believe that ingestion of more potassium, calcium, and magnesium may influence BP favorably. The beneficial effects of these ions work, at least in part, through an effect on sodium balance, i.e. a diuretic influence. In support of this concept, they lower BP more effectively in salt-sensitive hypertensives. Refined carbohydrates and saturated fats are also associated with salt retention and hypertension. Thus, dietary factors, working directly on their own and/or indirectly via effects on genetic mechanisms, may alter BP favorably or unfavorably.
人们普遍认为，遗传学在高血压的发病机制中起着重要作用。由于高血压常常在肾移植后出现，因此人们一直在大鼠和人类的肾脏中寻找并发现了候选基因。一种公认的、对血压（BP）的遗传性影响是通过体内肾钠处理异常发生的。此外，在遗传性高血压大鼠的离体肾脏中也观察到肾钠处理异常。那些相对无法正常处理钠负荷并不适当地潴留钠的人，往往会患上高血压，被称为“盐敏感型”。超过一半被诊断为原发性高血压的患者是盐敏感型。与高钠摄入相关的有害影响相反，许多人认为摄入更多的钾、钙和镁可能对血压产生有利影响。这些离子的有益作用至少部分是通过对钠平衡的影响，即利尿作用来实现的。支持这一概念的是，它们在盐敏感型高血压患者中能更有效地降低血压。精制碳水化合物和饱和脂肪也与钠潴留和高血压有关。因此，饮食因素直接作用于自身和/或通过对遗传机制的影响间接作用，可能对血压产生有利或不利的影响。
