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 Krekels, M. M. E. Articles by de Leeuw, P. W. Search for Related Content PubMed PubMed Citation Articles by Krekels, M. M. E. Articles by de Leeuw, P. W.

(Hypertension. 1997;30:1216-1222.)
© 1997 American Heart Association, Inc.

Articles

Sensitivity of Blood Pressure and Renin Activation During Sodium Restriction

Marielle M. E. Krekels; Nicolaas C. Schaper; Peter W. de Leeuw

From the Department of Medicine, University Hospital Maastricht, Maastricht, the Netherlands.

Correspondence and reprints to P.W. de Leeuw, MD, PhD, Department of Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, Netherlands.

Abstract The objective of the present study was to explore the interrelationships among cumulative sodium loss, renin activation, and blood pressure changes during sodium restriction in essential hypertensive patients. Specifically, we wanted to know whether the degree of sodium sensitivity of blood pressure depends on renin activation during steady state or on initial renin activation during the first days of sodium restriction. Sixty-seven untreated essential hypertensive patients were admitted to a metabolic ward for 8 days and put on a sodium restricted diet of 55 mmol/d from the second to the last day. Urinary excretions of sodium, potassium, and creatinine were determined along with mean arterial pressure and weight during 7 days. Besides measurements in steady state condition (after 7 days), active plasma renin concentration, aldosterone, and catecholamines were also assessed during the first 3 days of sodium restriction. Analyzable data are available for 55 patients. Baseline sodium excretion and the activation of renin during the first 3 days both appeared to be predictors of total sodium loss after 7 days. Changes in blood pressure were not related to changes in sodium balance, but they were to baseline blood pressure, baseline norepinephrine, and renin activation during the early phase of sodium restriction. In addition, blood pressure appeared to fall more when the normal relationship between sodium loss and early (but not late) activation of renin was disturbed. We conclude that sodium sensitivity of blood pressure during sodium restriction is associated with a relative unresponsiveness of the renin system during the early phase of sodium loss rather than to absolute renin levels during steady state.

Key Words: sodium sensitivity • renin • sodium balance

This article has been cited by other articles:

				N. Makhanova, J. Hagaman, H.-S. Kim, and O. Smithies Salt-Sensitive Blood Pressure in Mice With Increased Expression of Aldosterone Synthase Hypertension, January 1, 2008; 51(1): 134 - 140. [Abstract] [Full Text] [PDF]

				A. B. Weder Evolution and Hypertension Hypertension, February 1, 2007; 49(2): 260 - 265. [Full Text] [PDF]

				F. J He and G. A MacGregor Review: Salt, blood pressure and the renin-angiotensin system Journal of Renin-Angiotensin-Aldosterone System, March 1, 2003; 4(1): 11 - 16. [Abstract] [PDF]

				F. J. He, N. D. Markandu, and G. A. MacGregor Importance of the Renin System for Determining Blood Pressure Fall With Acute Salt Restriction in Hypertensive and Normotensive Whites Hypertension, September 1, 2001; 38(3): 321 - 325. [Abstract] [Full Text] [PDF]

				M. Johansson, M. Elam, B. Rundqvist, G. Eisenhofer, H. Herlitz, G. Lambert, and P. Friberg Increased Sympathetic Nerve Activity in Renovascular Hypertension Circulation, May 18, 1999; 99(19): 2537 - 2542. [Abstract] [Full Text] [PDF]