JAHA:钾摄入量增加对肾上腺皮质和血管紧张素II导致的心血管反应的影响

2021-04-20 MedSci原创 MedSci原创

在健康的血压正常男性中,钾摄入量增加会增强AngII刺激的醛固酮分泌,而不会影响全身性血液动力学指标。

钾摄入量的增加会降低高血压患者的血压,但钾摄入量的增加也会使具有升血压效应的激素-醛固酮血浆浓度升高。醛固酮除具有良好的肾脏作用外,还被认为具有血管效应,其通过存在于内皮和血管平滑肌细胞上的盐皮质激素受体来发挥作用,尽管目前认为与盐皮质激素受体无关的作用也参与其中。

为了进一步了解增加的钾摄入量和钾刺激的醛固酮增多症对人体心血管系统的影响,近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员在25名健康的血压正常的男性中进行了一项随机安慰剂对照双盲交叉研究。

该研究对4周内接受了钾补充治疗(90mmol/天)与安慰剂治疗4周的患者进行了比较。在每个治疗期结束时,研究人员测量了参与者血浆中的钾和醛固酮水平,并进行了血管紧张素II(AngII)输注实验,在此过程中,研究人员评估了参与者血浆中醛固酮的反应。在AngII输注期间,还使用ECG、阻抗心动图、手指体积描记法(血压监测)和多普勒超声对血流动力学指标进行了监测。

研究表明,较高的钾摄入量会增加血浆钾(平均值±SD为4.3±0.2 vs. 4.0±0.2 mmol/L;P=0.0002)和醛固酮(中位[四分位数间距]为440 [336-521] vs. 237 [173-386] pmol/L;P<0.0001)水平,并基于线性混合模型进行重复测量,钾摄入量增加增强了AngII刺激的醛固酮分泌(P=0.0020)。相反,钾和安慰剂后对AngII输注的血液动力学反应(血压、总外周阻力、心输出量和肾动脉血流量)相似。

由此可见,在健康的血压正常男性中,钾摄入量增加会增强AngII刺激的醛固酮分泌,而不会影响全身性血液动力学指标

原始出处:

Rasmus Dreier.et al.Effect of Increased Potassium Intake on Adrenal Cortical and Cardiovascular Responses to Angiotensin II: A Randomized Crossover Study.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.018716

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    2021-08-15 lmm397
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    2021-04-21 zhaohui6731
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    2021-04-20 ZJYYY7

    taught

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    2021-04-20 ZJYYY7

    了解、学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1895225, encodeId=b58f18952252a, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sun Sep 26 02:47:51 CST 2021, time=2021-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1860696, encodeId=cbde186069697, content=<a href='/topic/show?id=830b5693631' target=_blank style='color:#2F92EE;'>#摄入量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56936, encryptionId=830b5693631, topicName=摄入量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sun Aug 15 23:47:51 CST 2021, time=2021-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268503, encodeId=f47c1268503c8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Apr 21 20:47:51 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1506874, encodeId=7cb015068e4cf, content=<a href='/topic/show?id=26cf89e4530' target=_blank style='color:#2F92EE;'>#血管紧张素II#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89745, encryptionId=26cf89e4530, topicName=血管紧张素II)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ab559833295, createdName=bbwznl, createdTime=Wed Apr 21 20:47:51 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589363, encodeId=d3291589363ea, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Wed Apr 21 20:47:51 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958654, encodeId=87ee95865408, content=taught, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Tue Apr 20 09:29:48 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958652, encodeId=2465958652ac, content=了解、学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201214/b3170121d995432ea306ae3a7809cc05/2cfb236f361b4d3c80ef8fdef4301832.jpg, createdBy=8ad35400531, createdName=ZJYYY7, createdTime=Tue Apr 20 09:29:40 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958630, encodeId=97c6958630dc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210702/6007ed07799040abb56cdb566d5041aa/b7aa1e7ea0c84b91b63984abfacf46c6.jpg, createdBy=67225453303, createdName=KA-Evan, createdTime=Tue Apr 20 08:20:28 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958608, encodeId=2dff9586085e, content=加油, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/a00fa8771b6048248b9c662930fdbe07/99e523e1522e4bdf882bde51fa8a4c8c.jpg, createdBy=01fe3981478, createdName=139a948em49暂无昵称, createdTime=Tue Apr 20 06:07:56 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-20 KA-Evan

    学习

    0

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    2021-04-20 139a948em49暂无昵称

    加油

    0

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