Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial

Pimenta, Eduardo, Gaddam, Krishna K., Oparil, Suzanne, Aban, Inmaculada, Husain, Saima, Dell'Italia, Louis J. and Calhoun, David A. (2009) Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial. Hypertension, 54 3: 475-481. doi:10.1161/HYPERTENSIONAHA.109.131235


Author Pimenta, Eduardo
Gaddam, Krishna K.
Oparil, Suzanne
Aban, Inmaculada
Husain, Saima
Dell'Italia, Louis J.
Calhoun, David A.
Title Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial
Journal name Hypertension   Check publisher's open access policy
ISSN 0194-911X
Publication date 2009-09-01
Sub-type Article (original research)
DOI 10.1161/HYPERTENSIONAHA.109.131235
Open Access Status Not Open Access
Volume 54
Issue 3
Start page 475
End page 481
Total pages 7
Publisher American Heart Association
Language eng
Formatted abstract
Observational studies indicate a significant relation between dietary sodium and level of blood pressure. However, the role of salt sensitivity in the development of resistant hypertension is unknown. The present study examined the effects of dietary salt restriction on office and 24-hour ambulatory blood pressure in subjects with resistant hypertension. Twelve subjects with resistant hypertension entered into a randomized crossover evaluation of low (50 mmol/24 hours×7 days) and high sodium diets (250 mmol/24 hours×7 days) separated by a 2-week washout period. Brain natriuretic peptide; plasma renin activity; 24-hour urinary aldosterone, sodium, and potassium; 24-hour ambulatory blood pressure monitoring; aortic pulse wave velocity; and augmentation index were compared between dietary treatment periods. At baseline, subjects were on an average of 3.4±0.5 antihypertensive medications with a mean office BP of 145.8±10.8/83.9±11.2 mm Hg. Mean urinary sodium excretion was 46.1±26.8 versus 252.2±64.6 mmol/24 hours during low- versus high-salt intake. Low- compared to high-salt diet decreased office systolic and diastolic blood pressure by 22.7 and 9.1 mm Hg, respectively. Plasma renin activity increased whereas brain natriuretic peptide and creatinine clearance decreased during low-salt intake, indicative of intravascular volume reduction. These results indicate that excessive dietary sodium ingestion contributes importantly to resistance to antihypertensive treatment. Strategies to substantially reduce dietary salt intake should be part of the overall treatment of resistant hypertension.
Keyword blood pressure
hypertension
resistant hypertension
sodium
diet
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Fri, 04 Sep 2009, 20:21:28 EST