The Predictive Value of Salt Sensitivity and Osmotic Fragility in the Development of Cerebral Small Vessel Disease

Dobrynina, Larisa А.; Шабалина, А.А.; Шамтиева, К В; Gnedovskaya, E. V.; Бердалин, А. Б.; Кротенкова, М. В.

doi:10.3390/ijms21062036

Cited by 6 publications

(4 citation statements)

References 36 publications

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“… 9 ESS is a marker of erythrocyte sodium sensitivity and other studies have shown a relation between ESS and self‐reported sodium consumption, cerebrovascular disease, and end‐stage kidney disease. 30 , 31 , 32 Thus, ESS might be related to vascular damage, though our study does not support it as a good measure of SS of BP.…”

Section: Discussioncontrasting

confidence: 74%

Self‐Performed Dietary Sodium Reduction and Blood Pressure in Patients With Essential Hypertension: A Randomized Clinical Trial

Duus,

Nielsen,

Hornstrup

et al. 2024

JAHA

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Background Hypertension is the leading risk factor for cardiovascular disease worldwide. Patients with blood pressure (BP) response to dietary sodium reduction are referred to as “salt sensitive.” Salt sensitivity (SS) might be due to differences in sodium storage capacity and the erythrocyte SS examines this capacity of the red blood cells. This study aimed to test the effect of a self‐performed sodium reduced diet on BP in patients with essential hypertension and examine whether erythrocyte SS predicts SS. Methods and Results Seventy‐two patients with hypertension were included and randomized 2:1 to either sodium reduction or a control group for 4 weeks. Blood samples, 24‐hour BP measurement, and 24‐hour urine collection were performed before and after. The intervention group received advice on how to lower sodium intake. Urinary sodium excretion decreased 66 mmol (95% CI, −96 to −37 mmol) in the intervention group compared with the control group. Systolic 24‐hour BP decreased 9 mm Hg after low‐sodium diet compared with the control group (95% CI, −13 to −4 mm Hg). Similarly, the difference in reduction in diastolic BP between the groups was 5 mm Hg (95% CI, −8 to −1 mm Hg). We found no correlation between erythrocyte SS at baseline and decrease in 24‐hour BP, neither systolic nor diastolic ( P =0.66 and P = 0.84). Conclusions Self‐performed sodium reduction was feasible and led to decrease in 24‐hour BP of 9/5 mm Hg compared with a control group. The erythrocyte SS did not correlate to the change in BP after lowering sodium intake. Registration URL: https://clinicaltrials.gov ; Unique Identifier: NCT05165823.

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Section: Discussioncontrasting

confidence: 74%

Self‐Performed Dietary Sodium Reduction and Blood Pressure in Patients With Essential Hypertension: A Randomized Clinical Trial

Duus,

Nielsen,

Hornstrup

et al. 2024

JAHA

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“…6–8. 17–58 An additional 14 studies were excluded from the meta-analyses as they were repeated publications from the same cohort (n = 8); without complete data for meta-analysis (n = 4); and with unclear results reporting (n = 2). For multiple publications from the same cohort, we selected a representative study from each cohort based on the following: a greater number of cSVD markers reported, preference for more recent publications, and larger sample size.…”

Section: Resultsmentioning

confidence: 99%

The global burden of cerebral small vessel disease in low- and middle-income countries: A systematic review and meta-analysis

Lam

Yuan

Akinyemi

et al. 2022

International Journal of Stroke

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Background Cerebral small vessel disease (cSVD) is a major cause of stroke and dementia. Previous studies on the prevalence of cSVD are mostly based on single geographically-defined cohorts in high-income countries. Studies investigating the prevalence of cSVD in low- and middle-income countries (LMICs) are expanding but have not been systematically assessed. Aim This study aims to systematically review the prevalence of cSVD in LMICs. Results Articles were searched from the Ovid MEDLINE and EMBASE databases from 1st Jan 2000 to 31st March 2022, without language restrictions. Title/abstract screening, full-text review, and data extraction were performed by 2-7 independent reviewers. The prevalence of cSVD and study sample size were extracted by pre-defined world regions and health status. The Risk of Bias for Non-randomized Studies tool was used. The protocol was registered on PROSPERO (CRD42022311133). A meta-analysis of proportion was performed to assess the prevalence of different MRI markers of cSVD and a meta-regression was performed to investigate associations between cSVD prevalence and type of study, age, and male: female ratio. Of 2,743 studies identified, 42 spanning 12 global regions were included in the systematic review. Most of the identified studies were from China (n=23). The median prevalence of moderate-to-severe white matter hyperintensities (WMH) was 20.5%, 40.5%, and 58.4% in the community, stroke, and dementia groups, respectively. The median prevalence of lacunes was 0.8% and 33.52% in the community and stroke groups. The mean prevalence of cerebral microbleeds (CMB) was 10.7% and 22.4% in the community and stroke groups. The mean prevalence of moderate-to-severe perivascular spaces was 25.0% in the community. Meta-regression analyses showed that the weighted median age (51.4 ± 0.0 years old; range: 36.3-80.2) was a significant predictor of the prevalence of moderate-to-severe WMH and lacunes, while the type of study was a significant predictor of the prevalence of CMB. The heterogeneity of studies was high (> 95%). Male participants were overrepresented. Conclusions This systematic review and meta-analysis provide data on cSVD prevalence in LMICs and demonstrated the high prevalence of the condition. cSVD research in LMICs is being published at an increasing rate, especially between 2010-2022. More data is particularly needed from Sub-Saharan Africa & Central Europe, Eastern Europe & Central Asia.

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“…The lack of significant differences in ABPM results related to BBB permeability between patients and controls allow us to hypothesize the presence of additional factors of endothelial damage and increased BBB permeability alongside hypertension. These factors may be chronic inflammation 50 or high salt sensitivity, which have been found to independently correlate with CSVD 51 .…”

Section: Discussionmentioning

confidence: 99%

Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease

Dobrynina

Шамтиева

Кремнева

et al. 2022

Sci Rep

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Cerebral small vessel disease (CSVD) plays an important role in cognitive impairment, stroke, disability, and death. Hypertension is the main risk factor for CSVD. The use of antihypertensive therapy has not resulted in the expected decrease in CSVD complications, which may be related to the underestimation of significance of daily blood pressure profile for blood–brain barrier (BBB) permeability. 53 patients with CSVD of varying severity (mean age 60.08 ± 6.8 years, 69.8% women, subjects with treated long-standing hypertension vs. normotensive subjects − 84.8% vs. 15.2%) and 17 healthy volunteers underwent ambulatory blood pressure monitoring (ABPM) and MRI, including T1-weighted dynamic contrast-enhanced magnetic resonance imaging for assessing BBB permeability. Most of ABPM parameters in CSVD patients did not differ from controls, but were associated with the severity of white matter hyperintensity (WMH) and the total CSVD score. BBB permeability in normal-appearing white matter (NAWM) and grey matter (GM) was significantly higher in CSVD patients, and the severity of BBB permeability remained similar in patients with different stages of WMH. Among BBB permeability parameters, the area under the curve, corresponding to an increase in the contrast transit time in NAWM, had the greatest number of correlations with deviations of ABPM parameters. BBB permeability in CSVD is a universal mechanism of NAWM and GM damage associated with a slight increase in ABPM parameters. It is obvious that the treatment of hypertension in patients with not severe WMH should be more aggressive and carried out under the control of ABPM.

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The Predictive Value of Salt Sensitivity and Osmotic Fragility in the Development of Cerebral Small Vessel Disease

Cited by 6 publications

References 36 publications

Self‐Performed Dietary Sodium Reduction and Blood Pressure in Patients With Essential Hypertension: A Randomized Clinical Trial

Self‐Performed Dietary Sodium Reduction and Blood Pressure in Patients With Essential Hypertension: A Randomized Clinical Trial

The global burden of cerebral small vessel disease in low- and middle-income countries: A systematic review and meta-analysis

Daily blood pressure profile and blood–brain barrier permeability in patients with cerebral small vessel disease

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