血圧,レニン,アルドステロン,カテキオラミン,コレステロール,トリグリセリドに対するナトリウム制限の効果:メタ分析
N A Graudal1, A M Galløe, P Garred
1Department of Medicine, Gentofte Hospital, University of Copenhagen, Denmark.
JAMA
|May 15, 1998
まとめ
ナトリウム摂取量を減らすことは高血圧の個体では血圧を下げますが,正常血圧の個体では著しく低下しません. この食生活の変化は,体重や特定のホルモンに悪影響を及ぼし,一般的な推奨事項に疑問を呈する可能性があります.
科学分野:
- 予防医学は,予防的な医療です.
- 心血管の健康について
- 栄養科学とは,栄養科学である.
背景:
- 脳卒中や心筋梗塞を予防するために,一般的なナトリウム摂取量を減らすことの利点については論争があります.
- 新興の研究では,ナトリウム摂取量を減らすことの潜在的な有害効果が示唆されています.
研究 の 目的:
- 血圧 (BP),体重,および主要なホルモンに対する減量されたナトリウム摂取量の影響を定量化するために.
- ナトリウム還元によるBP効果の長期的な安定性を評価する.
主な方法:
- MEDLINE検索 (1966-1997) で特定されたランダム化比較試験 (RCT) の体系的レビュー.
- 含有基準:高ナトリウムと低ナトリウムダイエットを測定効果パラメータで比較した研究.
- データ抽出は,2人の著者によって独立して行われました.
主要な成果:
- 高血圧患者では,ナトリウム摂取量を減らした結果,シストリックBPを3.9mmHg,ダイアストリックBPを1.9mmHg大幅に低下させた.
- 血圧が正常な参加者では,血圧の低下は最小限であり,統計的に有意ではありませんでした.
- レニンとアルドステロン濃度の有意な増加が,ナトリウム減少に比例していることが観察されました.
- 体重は減少し,ノラドレナリンとLDLコレステロールは増加したが,トリグリセリドやHDLコレステロールには影響はなかった.
結論:
- 現在の証拠は,ナトリウムを減らすための普遍的な推奨を支持していません.
- ナトリウム制限は,高血圧の補助療法として役立つかもしれません.
- さらに長期的な研究,特に厳しい臨床エンドポイント (罹病率,生存率) を含む研究は,ナトリウム摂取をめぐる論争を解決するために必要である.
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