Dietary salt modulates the hypertensive effect of high aldosterone in subjects with resistant hypertension

Pimenta, Eduardo, Gaddam, Krishna, Pratt-Ubunama, Monique N., Nishizaka, Mari K. and Calhoun, David A. (2006). Dietary salt modulates the hypertensive effect of high aldosterone in subjects with resistant hypertension. In: Circulation. Abstracts From Scientific Sessions 2006. Scientific Sessions 2006, Chicago, IL, USA, (II-534-II-534). 12-15 November 2006.


Author Pimenta, Eduardo
Gaddam, Krishna
Pratt-Ubunama, Monique N.
Nishizaka, Mari K.
Calhoun, David A.
Title of paper Dietary salt modulates the hypertensive effect of high aldosterone in subjects with resistant hypertension
Conference name Scientific Sessions 2006
Conference location Chicago, IL, USA
Conference dates 12-15 November 2006
Proceedings title Circulation. Abstracts From Scientific Sessions 2006   Check publisher's open access policy
Journal name Circulation   Check publisher's open access policy
Place of Publication Baltimore, MD, United States
Publisher Lippincott, Williams & Wilkins
Publication Year 2006
Sub-type Published abstract
ISSN 0009-7322
1524-4539
Volume 114
Issue 18, Supplement
Start page II-534
End page II-534
Total pages 1
Language eng
Abstract/Summary Introduction: Aldosterone excess raises blood pressure levels and contributes to injury in target organs including the heart, kidneys, and brain. Experimental data suggest that the deleterious effects of aldosterone are dependent upon concomitant high dietary salt ingestion. However, no human studies have evaluated the interaction between dietary salt and hyperaldosteronism. Hypothesis: We tested the hypothesis that ambulatory blood pressure levels are related to the interaction of dietary salt and aldosterone in subjects with resistant hypertension. Methods: One hundred thirty-six subjects with resistant hypertension were prospectively evaluated by measurement of 24-hour urinary aldosterone (Ualdo) and sodium (UNa), and 24-hr ambulatory blood pressure monitoring (ABPM). Daytime, nighttime and 24-hr blood pressure (BP) as well as nocturnal blood pressure decline were determined. Subjects were designated as having high (Ualdo≥12 µg/24h) or normal (Ualdo<12 µg/24h) aldosterone excretion. Subjects were further divided into 3 groups according to urinary salt excretion: low (Una<125 mEq/24h), medium (125≤Una<225 mEq/24h), and high (Una≥225 mEq/24h). Results: Overall, the mean office blood pressure was 160.2/89.8 mmHg on an average of 4.1 medications. There was no difference in mean office BP values between the 72 subjects with normal Ualdo and the 64 subjects with high Ualdo. There was no difference in office and 24-hr BP levels in the normal Ualdo group regardless of urinary sodium excretion. In contrast, in the high Ualdo group, the office diastolic (89.2±2.7 vs 78.5±2.9mmHg, p=0.03), systolic daytime (149.0±3.2 vs 136.8±4.1mmHg, p=0.03), diastolic daytime (86.9±2.2 vs 77.3±2.9 mmHg, p=0.01), systolic nighttime (143.1±3.2 vs 127.7±5.4 mmHg, p=0.01), diastolic nighttime (81.4±2.3 vs 69.4±3.6 mmHg, p=0.006), 24-hour systolic (146.8±3.0 vs 133.4±4.1mmHg, p=0.01), and 24-hour diastolic (84.6±2.1 vs 74.5±3.2mmHg, p=0.01) BP were all higher in high compared to low urinary sodium excretion group. Conclusion: Reduced dietary salt ingestion blunts the hypertensive effects of high aldosterone levels. This is the first demonstration that dietary salt ingestion significantly modulates the clinical effects of aldosterone in humans.
Subjects 1103 Clinical Sciences
1102 Cardiovascular Medicine and Haematology
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown

 
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Created: Thu, 04 Mar 2010, 12:33:45 EST by Laura McTaggart on behalf of Mater Clinical School