Hipertensión y su relación con el sodio, el potasio, el calcio y el magnesio
DOI:
https://doi.org/10.17533/udea.penh.17876Palabras clave:
Hipertensión arterial, sodio, potasio, calcio, magnesio, alimentación saludable, dieta DASH.Resumen
La presión arterial (PA) elevada es uno de los principales factores de riesgo de la enfermedad, cardiaca, cerebrovascular y renal. Su aumento se debe entre otros a factores dietéticos, genéticos y a sus interacciones, entre otros. Un respaldo amplio de evidencia científica, apoya fuertemente el concepto de que los factores dietarios afectan la PA. Las modificaciones dietarias y de estilo de vida que disminuyen la PA son: la reducción del consumo de sal, deficiencia en calorías que induce a pérdida de peso, actividad física regular, moderación en la ingesta de alcohol, aumento en la ingesta de potasio y consumo de una dieta total saludable, como la dieta DASH (Dietary Approaches to Prevent and Treat Hypertension). Específicamente las personas de raza negra son más sensibles a la disminución de la PA, cuando se les reduce la ingesta de sal, se aumenta la de potasio y se les ofrece la dieta estilo DASH. Las personas de mayor edad, con alto riesgo de sufrir enfermedades secundarias a la PA elevada, de tipo cardíaco, cerebrovascular y renal, pueden mejorar sus cifras tensionales y prevenir la aparición de complicaciones cuando realizan modificaciones en su alimentación. De interés especial son los avances en estudios de experimentación animal, epidemiológicos y de ensayos clínicos, sobre la relación entre el incremento en el contenido de calcio en la dieta y el efecto protector contra la hipertensión arterial (HTA), no obstante aún continúan las investigaciones para validar dichos hallazgos. Con respecto al magnesio y su asociación con la disminución de la PA, los estudios no son concluyentes y falta aun más evidencia para reconocer su papel en la HTA.Descargas
Citas
Wang Y, Wang QJ. The prevalence of prehipertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004; 164: 2126-2134.
Fields LE, Burt VL, Cutler JA, Hughes J, Roccella EJ, Sorlie P. The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension 2004; 44:398-404.
Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003; 290:199-206.
González M., La Hoz F. Mortalidad por enfermedades cardiovasculares, Colombia, 1990-1999. Inf Quinc Epidemiol Nac 2002; (22): 417-444.
CIHTA. Comité interinstitucional del tratamiento de la HTA. Guías de manejo de la Hipertensión. Medellín; 1999. p. 9-12.
Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. The Seven Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 2003; 1-40.
Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997;157:2413-2446.
Lawrence J. A. Dietary approaches to prevent and treat hypertension a scientific statement from the American Heart Association. Hypertension. 2006; 47: 296-308.
World Health Organization (WHO)/. International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003; Nov; 21(11):1983-92.
Groff JJ, Gropper S. Macrominerales. En: Groff JJ, Gropper S. Advanced nutrition and human metabolism. 4a ed. Belmont: Wasworth; 2005; p. 408.
McCullough M, Lin PAO-HWA. Nutrition diet and hipertension En: Coulston AM, Rock CL, Monsen ER. Nutrition the prevention and treatment of disease. NewYork: Academic; 2001; p. 303-323.
Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA 2002; 288: 1723-1727.
Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in lood pressure among children and adolescents. JAMA 2004; 291:2107-2113.
Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003; 42:878-884.
TOHP Collaborative Research Group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with highnormal blood pressure The Trials of Hypertension Prevention, Phase II Arch Intern Med 1997; 157:657-667.
Whelton PK, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled Trial of Nonpharmacologic Interventions in the Elderly (TONE): TONE Collaborative Research Group JAMA 1998; 279:839-846.
Hecker KD. Effects of dietary animal and soy protein on cardiovascular disease risk factors Curr Atheroescler Rep 3:471 En: Mahan K, Escott-Stump S. Krauses’s Food nutrition & diet therapy. 11 ed. Philadelphia: Saunders; 11ed; 2004:911.
Okubo Y, Miyamoto T, Suwazono Y, Kobayashi E, Nogawa K. Alcohol consumption and blood pressure in Japanese men. Alcohol. 2001; 23:149-156.
Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: A metaanalysis of randomized, controlled trials. Ann Intern Med. 2002; 136: 493-503.
Klatsky AL, Friedman GD, Siegelaub AB, Gerard MJ. Alcohol consumption and blood pressure Kaiser-Permanente Multiphasic Health Examination data. N Engl J Med. 1977; 296:1194-1200.
Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2001; 38:1112-1117.
Xin X, He J, Frontini MG. Effects of alcohol reduction on blood pressure: A metaanalysis of randomized controlled trials. Hypertension 2001; 38:1112-7.
Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: A meta-analysis of randomized controlled trials. Hypertension 2000; 35: 838-43.
Appel LJ, DASH Collaborative Research Group a clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med.1997;336:1117-11-24.
Appel LJ. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA 2005; 294:2455-2464.
Sacks FM. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet: DASH-Sodium Collaborative Research Group. N Engl J Med. 2001; 344: 3-10.
Karanja NM, Obarzanek E, Lin PH, McCullough ML, Phillips KM, Swain JF, et al. Descriptive characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension Trial: DASH Collaborative Research Group. J Am Diet Assoc. 1999; 99:S19-S27.
Luft F Weinberger. Heterogenous responses to changes in dietary salt intake: the saltsensitivity paradigm: Am J Clin Nutr 1997; 65: 587S-35S.
Cowley A. Genetic and nongenetic determinants of salt and blood pressure Am J Clin Nutr 1997; 65: 587-935.
Steassen J, Lijnen P Thijs L Fagard L. Salt and blood pressure in community based intervention trials. Am J Clin Nutr 1997; 65:661S-70S.
He FJ, Markandu ND, MacGregor GA. Importance of the renin system for determining blood pressure fall with acute salt restriction in hypertensive and normotensive whites. Hypertension 2001; 38: 321-325.
Johnson RJ, Herrera-Acosta J, Schreiner GF, Rodriguez-Iturbe B. Subtle acquired renal injury as a mechanism of salt-sensitive hypertension. N Engl J Med. 2002;346:913-923.
Institute of Medicine of the National Academy. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Panel on dietary reference intakes for electrolytes and water: standing committee on the scientific evaluation of dietary reference intakes. Washington: Food and Nutrition Board; Washington 2004; p. 323-370.
Intersalt Cooperative Rearch Group. Intersalt. An international study of electrolite excretion and blood pressure: Results for 24 hours urinary sodium and potassium excretion.Br. Med. J. 1988; 279: 319-28.
Stamler J. The INERSALT study: Backgroundbackground, methods, finding and implications. Am J Clin Nutr 1997; 65 Suppl: 626S-42S.
Law Mr Frost CD, Wald NJ III. Analysis of data from trials of salt reduction Br Med J.1991; 302: 819-824.
Graudal NA; Galloe AM, Barred P. Effects of sodium restriction on blood pressure renin, aldosterone, catecholamines, cholesterols and trigliceride. JAMA 1998; 279: 1383-91.
Midgely, JP, Matthew, AG, Greenwood CMT, Logan, AG. Effects of reduce of dietary sodium on blood pressure. JAMA 1996; 275: 1590-97.
TOHP Collaborative Research Group. 1992b Erratum. The effects of non pharmacologic interventions on blood pressure of persons with high normal levels. Results of the trials of hypertension prevention, phase I. J Am Med AssocJAMA 1992;267:2330.
Morris RC Jr, Sebastian A, Forman A, Tanaka M, Schmidlin O. Normotensive salt sensitivity: effects of race and dietary potassium. Hypertension 1999;33:18-23.
Zhou B. The relationship of dietary animal protein and electrolytes to blood pressure: A study on three Chinese populations. Int J Epidemiol 1994: 23:716-722.
Cappuccio FP, MacGregor GA. Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertensens 1991; 9: 465-73.
Whelton PK. Effects of oral potassium on blood pressure: meta-analysis of randomized controlled clinical trials. JAMA 1997; 277:1624-1632.
Geleijnse JM, Kok FJ, Grobbee DE. Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. J. Hum. Hypertens. 2003; 17:471-80.
Naismith DJ, Braschi A. The effect of low-dose potassium supplementation on blood pressure in apparently healthy volunteers. Br J Nutr. 2003; 90:53-60.
Pang PK, Kaneko T, Benishin CG, Shan J, Lewanczuk RZ. Parathyroid function in hypertension. J Endocrinol Invest 1992; 15:79-85.
Hatton DC, McCarron DA. Dietary calcium and blood pressure in experimental models of hypertension: a review. Hypertension 1994; 23:513-30.
Allender PS, Cutler JA, Follmann D, Cappuccio FP, Pryer J, Elliott P. Dietary calcium and blood pressure: a meta-analysis of randomised clinical trials. Ann Intern Med 1996; 124: 825-31.
Cappuccio FP, Elliott P, Allender PS, Pryer J, Follman DA, Cutler JA. Epidemiologic association between dietary calcium intake and blood pressure: a meta-analysis of published data. Am J Epidemiol.1995; 142:935-945.
Bucher HC, Cook RJ, Guyatt GH, Lang JD, Cook DJ, Hatala R, Hunt DL et al. Effects of dietary calcium supplementation on blood pressure. A meta-analysis of randomised controlled trials JAMA 1996; 275:1016-22.
Food and Nutrition Board. Institute of Medicine. Dietary references intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington: National Academy Press; 1997; p.89-90. URL disponible en: http://books.nap.edu./catalog/10026.html. Fecha de acceso: noviembre 2005.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2024 Universidad de Antioquia
