Low Response of Renin–Angiotensin System to Sodium Intake Intervention in Chinese Hypertensive Patients

Abstract

The interactions of sodium balance and response of renin–angiotensin–aldosterone system are important for maintaining the hemodynamic stability in physiological conditions. However, the influence of short-term sodium intake intervention in the response of renin–angiotensin system (RAS) on hypertensive patients is still unclear. Thus, we conducted a clinical trial to investigate the effects of short-term sodium intake intervention on the response of RAS in hypertensive patients.One hundred twenty-five primary Chinese hypertensive patients were divided into high, moderate, and low sodium groups by 24-hour urinary sodium excretion (UNa+). All the patients received a 10-day dietary sodium intake intervention with standardized sodium (173.91mmol/day) and potassium (61.53mmol/day). Blood pressure, urinary sodium, urinary potassium, plasma sodium, potassium, creatinine, the levels of plasma renin activity, plasma angiotensin II concentrations (AT-II), and plasma aldosterone concentrations were detected before and after the intervention.Before the intervention, no differences were found in blood pressure and RAS among 3 groups. After standardized dietary sodium intake intervention, both UNa+ excretion and systolic pressure decreased in high-sodium group, while they increased in moderate and low-sodium groups. Intriguingly, there were no changes in the levels of plasma renin activity, AT-II, and plasma aldosterone concentrations among 3 groups during the intervention.The present study demonstrated that the influenced sodium excretion and blood pressure by short-term sodium intake intervention were independent of RAS quick response in Chinese hypertensive patients.

More evidence that salt increases blood pressure and risk of kidney disease from the Science of Salt: A regularly updated systematic review of salt and health outcomes (April–July 2016)

“…These studies are summarized in Table . The outcomes examined were diverse: one study assessed mortality outcomes (category I), two studies assessed morbidity outcomes (category II), two studies assessed outcomes related to symptoms/quality of life/functional status (category III), six studies assessed BP outcomes (category IV), seven studies assessed other clinically relevant surrogate outcomes (category V), and 10 studies assessed physiologic outcomes (category VI) …”

“…No primary research studies in the physiologic category (category VI) met the minimum methodological criteria. A range of outcomes were captured by the studies considered to be of lower quality, including all‐cause mortality, headaches/migranes, BP, cognitive function, acne, obesity and ghrelin, multiple sclerosis, BMD, gastric cancer, flow‐mediated dilatation, pulse wave velocity, markers of the renin‐angiotensin‐aldosterone system, heart rate, insulin resistance and the metabolic syndrome, brain tissue white matter hyperintensity, uric acid, and urinary albumin . Most of these studies found adverse effects of dietary salt on health, except for three that were neutral and one that found an inverse relationship between salt intake and headaches/migranes …”

Percentage of ingested sodium excreted in 24‐hour urine collections: A systematic review and meta‐analysis

“…Six additional studies were found from the reference lists of review articles that were identified during the literature search. A final 35 articles were included in the meta‐analysis (Appendix ).…”

Study on Relationships Between Dietary Mineral Intakes and Blood Pressure and Blood Lipid in TB patients

“…P is related to the physiological function of Ca and Mg. The epidemiological studies showed that trace elements Fe, Zn and Cu were related to the incidence of coronary artery disease, and the mechanism is related to vascular cell dysfunction and inflammatory reaction [13,14,15]. It was reported that the deficiency of Mg causes the inhibition of glucose tolerance, carbohydrate and lipid metabolism, and degradation of serum high density lipoprotein [16,17].…”