Exaggerated Natriuresis in Essential Hypertension

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  • Shimao Masato
    The First Department of Internal Medicine, School of Medicine, Kanazawa University

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  • 本態性高血圧症における塩類利尿にかんする研究
  • ホンタイセイ コウケツアツショウ ニ オケル エンルイ リニョウ ニ カンスル

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To clarify the mechanisms of exaggerated natriuresis in essential hypertention, urinary sodium excretion (UNa·V), mean blood pressure (MBP), plasma renin activity (PRA) and renal function were measured during the infusion of 1200 ml saline over 100 minutes in 20 hypertensives before and 2 weeks after administration of pindolol (15mg/day in 11 patients) and trichlormethiazide (6mg/day in 9 patients), and also in 8 normotensives. Before each saline infusion, plasma volume (PV) was measured in hypertensives.The results were as follows : 1) There were significant correlations between UNa·V and MBP in hypertensives without medication (r=0.562, p<0. 01), in normotensives and hypertensives without medication (r=0, 752, p<0.001) and in pindolol-treated group (r=0.769, p<0.01). In thiazide-treated proup, there was same teudency (r=0.628)2) UNa·V was also correlated with PRA in hypertensives (r= -0.472, p<0. 01).3) The slope of linear regression line of the correlation between UNa·V and MBP in thiazide-treated group was gradual than in pindolol-treated group. It is possible that PRA relates to this difference.4) There was no relationship between UNa·V and PV, or renal function.The results suggest that the most important factor for exaggerated natriuresis in essential hyperten-sion is level of MBP, but level of PRA is also implicated.

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