Grossman E, Vald A, Peleg E, Sela B, Rosenthal T
Chorley Hypertension Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Hum Hypertens. 1997 Dec;11(12):789-94. doi: 10.1038/sj.jhh.1000471.
Nutritional sodium, potassium and calcium are considered to be important regulators of blood pressure (BP). The present study evaluates the effects of combined low-sodium (LS), high-potassium (HK), high-calcium (HCa) diet on BP in patients with mild essential hypertension. Thirty-six patients (26 M, 10 F), 24-67 years of age (mean 46 +/- 8), participated in the study. Patients were divided into three groups and given a diet consisting of three 1-month segments, which they followed in different order. Group 1 (n = 11) received LS diet followed by the addition of HCa and then HK. The order in Group 2 (n = 12) was HK-LS-HCa; and in Group 3 (n = 13) it was HCa-HK-LS. The third month of the study all patients were eating a combined LS, HK and HCa diet. Urinary electrolytes were measured to confirm compliance with the diets. After 1 month of the LS diet urinary sodium excretion decreased significantly by 25 mmols/day (95% CI, 1-48 mmols/day); (P < 0.05). Eighteen patients did not comply with the diet. Systolic BP (SBP) only slightly decreased, from 142 mm Hg (95% CI, 137-146 mm Hg) to 138 mm Hg (95% CI, 133-142 mm Hg); (P = 0.11). The change in SBP was related to the change in urinary sodium excretion (R = 0.46; P = 0.006). After 1 month of the HK diet, urinary potassium excretion increased by only 5 mmols/day (P = NS). BP was unaffected by HK and HCa diet. At the end of the study, urinary sodium excretion decreased from 183 mmols/day (95% CI, 155-211 mmols/day) to 148 mmols/day (95% CI, 131-165 mmols/day); (P < 0.05), urinary potassium excretion slightly increased from 75 mmols/day (95% CI, 68-82 mmols/day) to 85 mmols/day (95% CI, 76-94 mmols/day); (P = 0.09), and urinary calcium excretion remained unchanged. BP did not decrease. It is concluded that only the LS diet may be advantageous in patients with mild essential hypertension.
膳食中的钠、钾和钙被认为是血压的重要调节因素。本研究评估低钠（LS）、高钾（HK）、高钙（HCa）联合饮食对轻度原发性高血压患者血压的影响。36例患者（男性26例，女性10例），年龄24 - 67岁（平均46±8岁）参与了本研究。患者被分为三组，给予为期三个月、分三个1个月阶段的饮食方案，且三个阶段按不同顺序进行。第一组（n = 11）先采用低钠饮食，然后添加高钙饮食，最后是高钾饮食。第二组（n = 12）的顺序是高钾 - 低钠 - 高钙；第三组（n = 13）是高钙 - 高钾 - 低钠。研究的第三个月，所有患者均采用低钠、高钾和高钙联合饮食。通过测量尿电解质来确认患者对饮食方案的依从性。低钠饮食1个月后，尿钠排泄量显著下降25 mmol/天（95%CI，1 - 48 mmol/天）；（P < 0.05）。18例患者未遵守饮食方案。收缩压（SBP）仅略有下降，从142 mmHg（95%CI，137 - 146 mmHg）降至138 mmHg（95%CI，133 - 142 mmHg）；（P = 0.11）。收缩压的变化与尿钠排泄量的变化相关（R = 0.46；P = 0.006）。高钾饮食1个月后，尿钾排泄量仅增加5 mmol/天（P = 无统计学意义）。血压不受高钾和高钙饮食的影响。研究结束时，尿钠排泄量从183 mmol/天（95%CI，155 - 211 mmol/天）降至148 mmol/天（95%CI，131 - 165 mmol/天）；（P < 0.05），尿钾排泄量从75 mmol/天（95%CI，68 - 82 mmol/天）略有增加至85 mmol/天（95%CI，76 - 94 mmol/天）；（P = 0.09），尿钙排泄量保持不变。血压并未下降。得出的结论是，对于轻度原发性高血压患者，仅低钠饮食可能有益。
