Salivary Electrolytes in Treated Hypertensives at Low or Normal Sodium Diet

Abstract

The aim of this study was to investigate possible abnormalities in salivary electrolytes in hypertensives treated with ace-inhibitors (ACE-I) or calcium antagonists (Ca-ANT) at low or normal sodium intake. Hypertensives treated with ACE-I (n.14) or Ca-ANT (n.22) and 13 normotensives were studied during normal or restricted Na intake. Na, K, Ca, Mg and Cl were determined in saliva samples collected by using a standardized adsorption procedure (SALIVETTE). Na intake was evaluated by determination of the 24-hr urinary Na excretion. Similar concentrations of Na, K, Ca, and Cl were found in normotensives and in hypertensives treated with ACEI or Ca-ANT both at low or normal Na diet. Magnesium in saliva appeared reduced in ACEI-treated hypertensives (0.28 +/- 0.06 mmol/l) in comparison to the similar values of normotensives (0.53 +/- 0.05) and Ca-ANT treated hypertensives (0.54 +/- 0.07). In normotensives and in treated hypertensives lowering of Na intake did not change the salivary content of Ca, Mg and Cl but produced in saliva a reduction of Na associated to a rise in K. Salivary Na/K ratio was significantly correlated with 24 hr urinary Na excretion in normotensives (r = 0.77; p < 0.05) and in hypertensives treated with ACE-I (r = 0.74; p < 0.05) or Ca-ANT (r = 0.62; p < 0.05). The low salivary magnesium in ACE-I-HT may have a role in the occasional ACEI-dependent dysgeusia. Salivary Na/K ratio may be used as a rough index of Na intake in treated hypertensives.

Differential Associations for Salivary Sodium, Potassium, Calcium, and Phosphate Levels with Carotid Intima Media Thickness, Heart Rate, and Arterial Stiffness

“…In contrast, the use of either calcium blockers or diuretics was not associated with the salivary electrolyte levels in the multivariate analysis. Likewise, the lack of alterations of salivary electrolytes by angiotensin-modifying medications (ACE inhibitors and AT1 receptor blockers) is consistent with previous observations in hypertensive subjects [10].…”

“…Interestingly, the Na/K ratio was inversed, with higher potassium and lower sodium in saliva as compared with plasma. These observations confirm previous observations [11] and may reflect the active sodium resorption in salivary glands by a Na-K-ATPase pump, which is responsive to aldosterone [10]. In contrast, potassium is actively released to the saliva by, for example, nerve stimulation.…”

“…These studies hence suggested a specific regulation of salivary ion concentrations in different diseases. Sodium, potassium, and other electrolytes in plasma have been extensively studied in relation to cardiovascular diseases and may reflect, for example, dietary intake [10], renal excretion [7], and activation of the renin-angiotensin and aldosterone systems [9, 11]. However, the predictive value of different salivary electrolytes for cardiovascular phenotypes has remained unexplored.…”

Hypertensive Patients and Their Management in Dentistry

“…Dysgeusia has also been reported with other antihypertensives use, like -blockers, acetazolamide, and diltiazem. It has been postulated that dysgeusia may result through a mechanism affecting salivary handling of metal ions such as magnesium [56,57].…”