This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Uzu, T. Articles by Kimura, G. Search for Related Content PubMed PubMed Citation Articles by Uzu, T. Articles by Kimura, G.

(Hypertension. 1996;28:139-142.)
© 1996 American Heart Association, Inc.

Articles

High Sodium Sensitivity Implicates Nocturnal Hypertension in Essential Hypertension

Takashi Uzu; Frida S. Kazembe; Kazuhiko Ishikawa; Satoko Nakamura; Takashi Inenaga; Genjiro Kimura

the Division of Nephrology, National Cardiovascular Center, Osaka, Japan.

We investigated the relationship between sodium sensitivity and diurnal variation of blood pressure in patients with essential hypertension. Twenty-eight inpatients with essential hypertension were maintained on high sodium (12 to 15 g NaCl per day) and low sodium (1 to 3 g NaCl per day) diets for 1 week each. Twenty-four-hour blood pressure and urinary sodium excretion were measured at the end of each diet period, and the sodium sensitivity index was calculated as the ratio of the change in mean arterial pressure to the change in urinary sodium excretion rate by sodium restriction. Patients whose average mean arterial pressure was lowered more than 10% by sodium restriction were assigned to the sodium-sensitive group (n=16); the remaining patients, whose mean arterial pressure was lowered by less than 10%, were assigned to the non-sodium-sensitive group (n=12). In the non-sodium-sensitive group, mean arterial pressure and heart rate fell during the nighttime, and average values of systolic, diastolic, and mean arterial pressures during the night were significantly lower than those during the day during both low and high sodium diets. On the other hand, in the sodium-sensitive group, there was no nocturnal fall in mean arterial pressure, and none of the systolic, diastolic, and mean arterial pressure values during the nighttime was different from the respective pressure values during the daytime during either sodium diet. The sodium sensitivity index was positively correlated with the fall in mean arterial pressure during the nighttime during a high sodium diet (r=.55, P<.01). These results indicate that in patients with sodium-sensitive essential hypertension, blood pressure fails to fall during the night. High sodium sensitivity may be a marker of greater risk of renal and cardiovascular complications, as has been found in nondippers, patients whose blood pressure fails to fall during the night.

Key Words: sodium • blood pressure • natriuresis • circadian rhythm

This article has been cited by other articles:

				M. Fukuda, M. Mizuno, T. Yamanaka, M. Motokawa, Y. Shirasawa, T. Nishio, S. Miyagi, A. Yoshida, and G. Kimura Patients With Renal Dysfunction Require a Longer Duration Until Blood Pressure Dips During the Night Hypertension, December 1, 2008; 52(6): 1155 - 1160. [Abstract] [Full Text] [PDF]

				G. Kimura Kidney and Circadian Blood Pressure Rhythm Hypertension, April 1, 2008; 51(4): 827 - 828. [Full Text] [PDF]

				A. Sachdeva and A. B. Weder Nocturnal Sodium Excretion, Blood Pressure Dipping, and Sodium Sensitivity Hypertension, October 1, 2006; 48(4): 527 - 533. [Full Text] [PDF]

				M. Fukuda, M. Motokawa, S. Miyagi, K. Sengo, W. Muramatsu, N. Kato, T. Usami, A. Yoshida, and G. Kimura Polynocturia in chronic kidney disease is related to natriuresis rather than to water diuresis Nephrol. Dial. Transplant., August 1, 2006; 21(8): 2172 - 2177. [Abstract] [Full Text] [PDF]

				T. Mohri, N. Emoto, H. Nonaka, H. Fukuya, K. Yagita, H. Okamura, and M. Yokoyama Alterations of Circadian Expressions of Clock Genes in Dahl Salt-Sensitive Rats Fed a High-Salt Diet Hypertension, August 1, 2003; 42(2): 189 - 194. [Abstract] [Full Text] [PDF]

				A. Chiolero, G. Wurzner, and M. Burnier Renal determinants of the salt sensitivity of blood pressure Nephrol. Dial. Transplant., March 1, 2001; 16(3): 452 - 458. [Full Text] [PDF]

				M. Suzuki, Y. Kimura, M. Tsushima, and Y. Harano Association of Insulin Resistance With Salt Sensitivity and Nocturnal Fall of Blood Pressure Hypertension, April 1, 2000; 35(4): 864 - 868. [Abstract] [Full Text] [PDF]

				C. Di Gennaro, A. Barilli, C. Giuffredi, C. Gatti, A. Montanari, and P. P. Vescovi Sodium Sensitivity of Blood Pressure in Long-Term Detoxified Alcoholics Hypertension, April 1, 2000; 35(4): 869 - 874. [Abstract] [Full Text] [PDF]

				T. Uzu and G. Kimura Diuretics Shift Circadian Rhythm of Blood Pressure From Nondipper to Dipper in Essential Hypertension Circulation, October 12, 1999; 100(15): 1635 - 1638. [Abstract] [Full Text] [PDF]

				K. Kario, J. E. Schwartz, and T. G. Pickering Ambulatory Physical Activity as a Determinant of Diurnal Blood Pressure Variation Hypertension, October 1, 1999; 34(4): 685 - 691. [Abstract] [Full Text] [PDF]

				P. Li, S. H. Sur, R. E. Mistlberger, and M. Morris Circadian blood pressure and heart rate rhythms in mice Am J Physiol Regulatory Integrative Comp Physiol, February 1, 1999; 276(2): R500 - R504. [Abstract] [Full Text] [PDF]

				P. Li, M. Morris, C. M. Ferrario, C. Barrett, D. Ganten, and M. F. Callahan Cardiovascular, endocrine, and body fluid-electrolyte responses to salt loading in mRen-2 transgenic rats Am J Physiol Heart Circ Physiol, October 1, 1998; 275(4): H1130 - H1137. [Abstract] [Full Text] [PDF]

				T. Uzu, K. Ishikawa, T. Fujii, S. Nakamura, T. Inenaga, and G. Kimura Sodium Restriction Shifts Circadian Rhythm of Blood Pressure From Nondipper to Dipper in Essential Hypertension Circulation, September 16, 1997; 96(6): 1859 - 1862. [Abstract] [Full Text]