塩分敏感性高血圧における塩による血エンドセリンの調節
F Elijovich1, C L Laffer, E Amador
1Section of Hypertension, University of Texas Medical Branch at Galveston, USA. Fernando_Elijovich@grmerc.net
Circulation
|February 24, 2001
まとめ
高血圧患者では,より高いエンドセリン濃度が塩分感受性に関連しています. 塩分が少なく,塩分に敏感な個体は,カテキオラミンによって刺激されたエンドセリンの増加を示し,エンドセリン受容体阻害剤の潜在的な利益を示唆しています.
科学分野:
- 心血管生理学 心血管の生理学
- エンドクリノロジー エンドクリノロジー
- 高血圧の研究 高血圧の研究
背景:
- 塩に依存した血圧調節は,実験的な高血圧モデルにおいて極めて重要です.
- エンドセリンは重要な血管収縮剤であるが,ヒトの高血圧における塩分バランスの調節は十分に研究されていない.
研究 の 目的:
- 人間の本質的高血圧における塩バランスによるプラズマエンドセリンの調節を調査する.
- 塩分感受性,エンドセリン,カテキオラミン,およびプラズマレニン活性 (PRA) の間の関係を調査する.
主な方法:
- 47人の高血圧患者と20人の対照群で血エンドセリンを測定した.
- 29人の患者で24時間のナトリウム欠乏に対するエンドセリン,カテキアミン,PRAの反応を評価した.
- 血圧がナトリウム減少に対する反応に基づいて,塩に敏感,耐性,および未定のグループに分類した患者.
主要な成果:
- 高血圧の患者は,対照群よりもベースラインのエンドセリン値が高く,血圧と相関し,PRAと逆相関していた.
- 塩分に敏感な患者は,塩分欠乏後のPRA反応が鈍化し,カテキオラミンとエンドセリンが有意に増加した.
- 塩分不足状態におけるエンドセリン濃度は,塩分に敏感な患者で最高であり,カテキオラミン変化と相関していた.
結論:
- 塩分が乏しく,塩分に敏感な高血圧患者でレニン反応が低下すると,カテキオラミン刺激によるエンドセリンの値が上昇します.
- これらの発見は,エンドセリン受容体阻害剤が,塩に敏感な高血圧患者においてより効果的かもしれないことを示唆している.
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