Factors influencing blood pressure in salt-sensitive patients with hypertension

Fujita, Toshiro; Henry, W L; Bartter, Frederic C.; Lake, C. Raymond; Delea, Catherine S.

doi:10.1016/0002-9343(80)90002-9

Cited by 359 publications

(169 citation statements)

References 27 publications

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“…It has been reported that plasma norepinephrine concentration and urinary norepinephrine excretion are elevated during the daytime and reduced during sleep (12,13). In the present study patients with essential hypertension were divided into two groups according to their sodium sensitivities (14,15). Six out of 14 patients with essential hypertension were classified as salt sensitive hypertensives.…”

Section: Discussionmentioning

confidence: 87%

Diurnal Variation of Blood Pressure in Patients with Salt Sensitive Hypertension.

et al. 1993

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Variations of blood pressure (BP) and heart rate (HR) were evaluated in patients with essential hypertension (EH) under the conditions of low salt and high salt intake. Fourteen patients with EH were hospitalized and consecutively kept on a daily salt intake of 3 and 20 g for 1 week each. Variations in BP were measured at intervals of 15 or 30 min using automatic noninvasive BP recorders.Urinary excretion of norepinephrine (UNEV) was also measured serially. The patients whose mean BP was increased more than 10 % by salt loading were classified as salt sensitive hypertensives (SS; n = 6), while the rest were defined as salt resistant hypertensives (SR; n = 8). In SR, averages of both systolic and diastolic blood pressure at night were significantly lower than those during the daytime for both low salt and high salt conditions. UNEV in SR was also decreased significantly at night in both conditions. In 55, however, the nocturnal fall in blood pressure was not significant during salt loading. Furthermore, in 55, UNEV was not decreased significantly during the night in either condition. These results suggest that salt loading in addition to incomplete inhibition of the sympathetic nervous system at night may be involved in the absence of a nocturnal decrease in BP in patients with salt sensitive hypertension. (Hypertens Res 1993; 16: 233-237)

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Section: Discussionmentioning

confidence: 87%

Diurnal Variation of Blood Pressure in Patients with Salt Sensitive Hypertension.

et al. 1993

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“…18,21 K Sensitivity and resistance to the effects of sodium were evaluated by the degree of BP change between high-salt diet and low-salt diet. [22][23][24] What this study adds K A new simple method to monitor daily salt intake was developed. K Self-monitoring of morning blood pressure and daily salt intake by this device for more than 3 weeks and examining the relationship with use of 3-day moving average will be useful to identify who is salt sensitive.…”

Section: Referencesmentioning

confidence: 99%

“…Sensitivity and resistance to the effects of salt have been evaluated by the degree of blood pressure change between high-salt intake and low-salt diet. [22][23][24] Recent reports suggest that morning surge is closely related to incidence of cardiovascular and cerebrovascular diseases. 25,26 Blood pressure and salt intake differ in individuals and on different days.…”

Section: Introductionmentioning

confidence: 99%

Self-monitoring of home blood pressure with estimation of daily salt intake using a new electrical device

Yamasue

Tochikubo

Kono³

et al. 2006

J Hum Hypertens

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We investigated a simple device to monitor daily salt intake at home and examined the relationship between salt excretion and morning blood pressure in order to enable patients to better manage daily salt intake and hypertension. The correlation between 24-h urinary salt excretion and measured value with salt monitor from overnight urine was significant (n ¼ 224, r ¼ 0.72, Po0.001). A total of 46 volunteers participated for more than 3 weeks by measuring daily salt intake and morning blood pressure. The relationship between predicted daily salt excretion and blood pressure was examined with use of 3-day moving average. Mean salt excretion and systolic blood pressure (SBP) significantly decreased by the end of the trial (i.e., salt excretion decreased from 158731 to 149730 mmol/day and SBP from 137717 to 133716 mm Hg). Of 46 participants, 18 (39%) had a significant correlation between predicted daily salt excretion and blood pressure (r40.4, Po0.05, n421), indicating sodium sensitivity. An additional 17% had a positive correlation that did not reach statistical significance (0.2orp0.4), and the remaining 44% had no correlation (rp0.2). Mean decrease in blood pressure per decrease in salt (g) (17 mmol) intake in the 18 participants with a significant correlation was 3.3 mm Hg (SBP) and 1.5 mm Hg (diastolic blood pressure), which was higher than that reported for other studies. Hypertensive patients not using medication showed the largest decrease. We conclude that daily monitoring of salt intake and morning blood pressure will be useful for management of hypertension.

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“…A large proportion of individuals with essential hypertension are salt-sensitive (Kawasaki et al, 1978;Fujita et al, 1980;Weinberger, 1996) and this salt sensitivity is considered to be a marker of the potential for cardiovascular disease (Morimoto et al, 1997;Raij, 1999). A high salt intake has been recognized to be closely correlated with blood pressure elevation (Dahl et al, 1967;Tobian, 1991).…”

Section: Introductionmentioning

confidence: 99%

“…However, the underlying mechanism of how salt intake induces hypertension is not yet clearly understood. It has been demonstrated that a high salt intake in hypertensive patients enhances sympathetic nerve activity and disturbs the renin-angiotensin system, leading to an increase in peripheral vascular resistance (Fujita et al, 1980;Williams & Hollenberg, 1991). In Dahl salt-sensitive hypertensive rats, a high salt diet has been shown to impair endothelium-dependent relaxations induced by a variety of vasodilators (LuÈ scher et al, 1987;Raij et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

Downregulation of vascular soluble guanylate cyclase induced by high salt intake in spontaneously hypertensive rats

Kagota

Tamashiro

Yamaguchi

et al. 2001

British J Pharmacology

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1 Cyclic guanosine monophosphate (cyclic GMP)-mediated mechanism plays an important role in vasodilatation and blood pressure regulation. We investigated the e ects of high salt intake on the nitric oxide (NO) ± cyclic GMP signal transduction pathway regulating relaxation in aortas of spontaneously hypertensive rats (SHR). 2 Four-week-old SHR and normotensive Wistar-Kyoto rats (WKY) received a normal salt diet (0.3% NaCl) or a high salt diet (8% NaCl) for 4 weeks. 3 In aortic rings from SHR, endothelium-dependent relaxations in response to acetylcholine (ACh), adenosine diphosphate (ADP) and calcium ionophore A23187 were signi®cantly impaired by the high salt intake. The endothelium-independent relaxations in response to sodium nitroprusside (SNP) and nitroglycerin were also impaired, but that to 8-bromo-cyclic GMP remained unchanged. On the other hand, high salt diet had no signi®cant e ects on the relaxations of aortic rings from WKY. 4 In aortas from SHR, the release of NO stimulated by ACh was signi®cantly enhanced, whereas the production of cyclic GMP induced by either ACh or SNP was decreased by the high salt intake. 5 Western blot analysis showed that the protein level of endothelial NO synthase (eNOS) was slightly increased, whereas that of soluble guanylate cyclase (sGC) was dramatically reduced by the high salt intake. 6 These results indicate that in SHR, excessive dietary salt can result in downregulation of sGC followed by decreased cyclic GMP production, which leads to impairment of vascular relaxation in responses to NO. It is notable that chronic high salt intake impairs the sGC/cyclic GMP pathway but not the eNOS/NO pathway.

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Factors influencing blood pressure in salt-sensitive patients with hypertension

Cited by 359 publications

References 27 publications

Diurnal Variation of Blood Pressure in Patients with Salt Sensitive Hypertension.

Diurnal Variation of Blood Pressure in Patients with Salt Sensitive Hypertension.

Self-monitoring of home blood pressure with estimation of daily salt intake using a new electrical device

Downregulation of vascular soluble guanylate cyclase induced by high salt intake in spontaneously hypertensive rats

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