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La ingesta de sal y el tratamiento diurético de la hipertensión
Lancet (London, England)
|July 21, 1979
Resumen
Este estudio encontró que el aumento de la ingesta de sal no limita la eficacia diurética de tiazida en la hipertensión. La estimulación progresiva del sistema renina-angiotensina, no el apetito por la sal, puede limitar el control de la presión arterial con diuréticos.
Área de la Ciencia:
- Nefrología Nefrología.
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Farmacología Farmacología.
Sus antecedentes:
- Los diuréticos tiazídicos son tratamientos comunes para la hipertensión esencial.
- El mecanismo que limita su eficacia antihipertensiva a largo plazo no se entiende completamente.
- Se ha planteado la hipótesis de que el aumento del apetito por la sal debido al agotamiento de la sal es un factor limitante.
Objetivo del estudio:
- Investigar si el aumento de la ingesta de sal limita la acción antihipertensiva de los diuréticos tiazídicos.
- Determinar el papel del sistema renina-angiotensina en la eficacia a largo plazo de los diuréticos tiazídicos.
Principales métodos:
- La excreción de sodio en orina durante 24 horas fue monitoreada en 36 pacientes con hipertensión esencial.
- Los pacientes fueron tratados con bendrofluazida durante 2 años.
- Los niveles de renina plasmática se midieron durante todo el período del estudio.
Principales resultados:
- La excreción urinaria de sodio se mantuvo estable durante 2 años de tratamiento con bendrofluazida.
- Los niveles plasmáticos de renina aumentaron progresivamente durante 2 años, incluso en pacientes que inicialmente no fueron estimulados por diuréticos.
- No se encontró evidencia de un aumento en la ingesta de sal que limite la eficacia diurética.
Conclusiones:
- El aumento del apetito por la sal no parece limitar la eficacia antihipertensiva de los diuréticos tiazídicos.
- La estimulación progresiva del sistema renina-angiotensina puede ser un factor clave que limita el efecto a largo plazo de los diuréticos para bajar la presión arterial.
- El efecto antihipertensivo de la restricción de sal en la dieta también podría estar limitado por mecanismos similares.
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