UMIN-CTR 臨床試験登録情報の閲覧

8 例が参加
血圧日内リズム改善には日中の尿中Na排泄増加が先行したのみならず，日内リズムがいまだ改善していない症例でも日中の尿中Na排泄が増していた。以上のことから「以前我々が報告したARBによる日中Na排泄増加」は夜間降圧の結果ではなく，日中Na排泄増加が夜間降圧をもたらすとの仮説が支持された。
(J Renin Angiotensin Aldosterone Syst. 2014 May 15)

Eight patients provided informed consent.
At baseline, three of the eight patients had dipper circadian BP rhythm and five had non-dipper BP rhythm. The three dippers at baseline exhibited an increase in daytime natriuresis (UNaV) within 2 days after starting ARB treatment. One of the five non-dippers showed an increase in UNaV on the first day of treatment and the rhythm was restored to a dipper pattern on the same day. The other four non-dippers at baseline had no change in this status in the first 2 days of treatment. However, all four patients had an increase in daytime UNaV within 2 days after starting treatment (1 day for three patients; 2 days for one patient), even though circadian BP rhythm was not restored.  These findings indicate that the increase in daytime UNaV is not attributable to BP reduction during the previous night. Rather, the increase in daytime UNaV can restore the circadian BP rhythm. We postulate that diuretics suppress most of the FRNa at their action site, whereas ARBs suppress inappropriate enhancement of FRNa stimulated by intrarenal RAS.
(J Renin Angiotensin Aldosterone Syst. 2014 May 15)