(Hypertension. 1997;30:163-167.)
© 1997 American Heart Association, Inc.
Articles |
Nocturnal Decline in Blood Pressure Is Attenuated by NaCl Loading in Salt-Sensitive Patients With Essential Hypertension
Noninvasive 24-Hour Ambulatory Blood Pressure Monitoring
From the First Department of Internal Medicine (Y.H., H.M., G.K.) and Department of Clinical Laboratory Medicine (T.O., R.O., Y.N., M.K.), Hiroshima University School of Medicine (Japan).
Correspondence to Yukihito Higashi, MD, First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734, Japan. E-mail yhigashi{at}mcai.med.hiroshima-u.ac.jp
Abstract We investigated the effect of NaCl on the circadian
blood pressure rhythm in patients with essential hypertension
classified according to the presence or absence of salt sensitivity. We
obtained 24-hour noninvasive ambulatory blood pressure measurements in
64 Japanese patients with mild to moderate essential hypertension who
ate a low NaCl diet (50 mmol/d) for 1 week, followed by a high
NaCl diet (340 mmol/d) for 1 week. Twenty-six patients whose mean
blood pressure was increased more than 10% by NaCl loading were
classified as salt sensitive. The remaining 38 patients were classified
as salt resistant. The nocturnal decline in mean blood pressure
was significantly smaller in salt-sensitive patients (8.3±1.0%) than
in salt-resistant patients (11.5±0.9%) (P<.05)
during a high NaCl diet but was similar in both groups during a low
NaCl diet. There was no significant difference in the prevalence of the
non-dipper pattern between groups on a low NaCl diet, but the
prevalence of the non-dipper pattern was significantly higher in
salt-sensitive patients than in salt-resistant patients on a
high NaCl diet (0.57 versus 0.26, 
2=6.4;
P=.02; odds ratio, 3.82). These findings suggest that the
NaCl loading blunted the nocturnal decline in blood pressure in
salt-sensitive patients but not in salt-resistant patients.
Key Words: blood pressure monitoring, ambulatory • circadian rhythm • hypertension, essential • sodium
This article has been cited by other articles:
 |
|
 |
|
  R. D. Rudic and D. J. Fulton Pressed for time: the circadian clock and hypertension J Appl Physiol, October 1, 2009; 107(4): 1328 - 1338. [Abstract] [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]
|
|
|
|
 |
|
 Y. Higashi, K. Nakagawa, M. Kimura, K. Noma, K. Hara, S. Sasaki, C. Goto, T. Oshima, K. Chayama, and M. Yoshizumi Circadian variation of blood pressure and endothelial function in patients with essential hypertension: a comparison of dippers and non-dippers J. Am. Coll. Cardiol., December 4, 2002; 40(11): 2039 - 2043. [Abstract] [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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|