Hypertension:钠饮食摄入与肾钠处理功能的相互作用可影响血压

2013-09-03 佚名 丁香园

图1.不同的锂排泄分数三分位组中,夜间舒张压与钠排泄的关系。 图2.夜间收缩压与钠饮食摄入与肾钠处理功能的相互作用的关系。 研究要点: 钠饮食摄入和近端肾小管的钠处理功能相互作用,从而影响血压水平。 低钠饮食对于控制血压及降低肾功损害都有着长远的益处。 大量的研究指出钠摄入量与血压水平相关,但是,这种相关度在个体之间存在明显的差异,且多种因素可影响两者的相关性强度。为此,


图1.不同的锂排泄分数三分位组中,夜间舒张压与钠排泄的关系。


图2.夜间收缩压与钠饮食摄入与肾钠处理功能的相互作用的关系。

研究要点:

钠饮食摄入和近端肾小管的钠处理功能相互作用,从而影响血压水平。

低钠饮食对于控制血压及降低肾功损害都有着长远的益处。

大量的研究指出钠摄入量与血压水平相关,但是,这种相关度在个体之间存在明显的差异,且多种因素可影响两者的相关性强度。为此,来自上海交通大学瑞金医院王继光等从钠饮食摄入与肾钠处理功能的关系为研究点进行了相关临床试验,研究发现钠饮食摄入与肾钠处理功能的相互作用可影响血压。该研究论文发表于8月Hypertension杂志。【原文下载

研究人员选取了766名受检者,其中男性379名,动态血压异常患者478名;有697名受检者从未接受过降压药物治疗,69名超过两周未接受降压药物治疗。研究测量了24小时尿钠排泄及内源锂清除率来分别评估钠饮食摄入与肾钠处理功能,同时,研究者测量了锂排泄分数及远端的钠重吸收率分别作为近端和远端的肾钠处理功能参数。

调整处理后统计结果显示尿钠排泄,锂排泄分数及远端钠重吸收分数等因素与临床或动态血压水平并没有明显的相关性;但是,在夜间舒张血压方面,尿钠排泄和锂排泄分数有明显的相互影响作用。除去锂排泄分数三分位组的1号组,在其余两组,夜间舒张血压与尿钠排泄成正相关;然而,锂排泄分数1号组的夜间舒张血压水平要明显高于3号组,而且在钠排泄分数的最低组更为明显。在夜间收缩血压,临床或动态24小时血压方面也有相似的趋势。

王继光等人认为该研究指出了钠饮食摄入和近端肾小管的钠处理功能相互作用,从而影响血压水平。低钠饮食对于控制血压及降低肾功损害都有着长远的益处。

原文下载

Zou J, Li Y, Yan CH, Wei FF, Zhang L, Wang JG.Blood Pressure in Relation to Interactions Between Sodium Dietary Intake and Renal Handling.Hypertension. 2013 Aug 19.

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    2014-05-01 feather89
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    2013-09-05 ylz8405
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据7月3日发表在JAMA(《美国医学会杂志》)上的一则研究披露,与常规治疗相比,由药剂师进行管理的居家血压(BP)远程监控组成的一种干预治疗在12个月的时间段内达到了改善血压控制和血压下降的效果,并且在该干预之后血压的改善维持了6个月的时间。 根据文章的背景资料:“高血压是最常见的慢性疾病,病人会因为该疾病病而到初级保健医生处就诊;该疾病对美国30%的成年人造成影响;据估计每年在高血压上所花费的

Ann Intern Med:严格控制血压对老年慢性肾病患者可能有害

一项针对美国退伍军人的大型全国队列研究显示,在非透析依赖性慢性肾病患者中,收缩压和舒张压较低者的死亡率确实更低,但是一旦舒张压低于70 mmHg,这一关联就不复存在了。该研究结果发表在《内科学年鉴》上[Ann Intern Med. 2013;159(4):233-242]。不仅如此,主要研究者、孟菲斯退伍军人事务部医疗中心肾病科主任Csaba P. Kovesdy医生指出,具有“理想”血压值(低