The effect of sodium load on hypertension

• Main Authors: KWAN-DUN WU, 吳寬墩
• Other Authors: Tsan-Shin Yen
• Format: Others
• Language: zh-TW
• Published: 1993
• Online Access: http://ndltd.ncl.edu.tw/handle/45770097466076442875

博士 === 國立臺灣大學 === 臨床醫學研究所 === 81 === Essential hypertension (EH) is a multifactorial disease. Epidemilolgical data reveal strong positive correlation between blood pressure (BP) amd salt intake. However the interrelation- ships of salt intake, body sodium and BP are very complicated, and the pathophysiological mechanism of hypertension caused by high salt intake is still unknown. We studied the interrelation- ships between sodium load ypertension from several aspects. The response of natriuresis and BP to acute manipulations of body volume by furosemide and saline infusion were evaluated in EH. salt-sensitive (SS) hypertensive were defined by 5% decrease in mean BP after furosemide administration. The results suggest that natriuretic response to saline infusion may reflect sodium -volume sensitvity in hypertensive patients. The exaggerated natriuresis in SS hypertensives during acute sodium loading may function as a protective mechanism to prevent abrupt increase in blood volume and BP. During acute salt loading in EH , the "fast responders" whose atrial natriuretic peptide (ANP) levels increased promptly in 2 hours during saline infusion, had greater extent of natriuresis and less change of BP than those had no increase of their ANP until the end of saline infusion. The results indicate that ANP plays an important role in the natriuresis and hemodynamic stability in hypentensive patients during acute sodium loading . The acute hypotensives effect of nicardipine (a calcium channel blocker), not different between SS and salt- resistant hypertensives,was dependent upon the vas- cular tone regard less of that status of the RAA system. SS patients had blunt baroreflex, which might account for the less increase in plasma reninactivity and greater decrease in plasma aldosterone concentration after nicardipine treatment.