| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 2001;38:321.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Importance of the Renin System for Determining Blood Pressure Fall With Acute Salt Restriction in Hypertensive and Normotensive Whites
Blood Pressure Unit, St. George’s Hospital Medical School, London, United Kingdom.
Correspondence to Prof G.A. MacGregor, Blood Pressure Unit, St. George’s Hospital Medical School, Cranmer Terrace, London, SW17 0RE, UK. E-mail g.macgregor{at}sghms.ac.uk
Abstract—— Hypertensive (n=93) and normotensive (n=39) white individuals were given a high sodium intake of 
350 mmol/d for 5 days followed by a low sodium intake of 10 to 20 mmol/d for 5 days. With this acute and large reduction in salt intake, no significant change was seen in blood pressure in the normotensive individuals, but blood pressure decreased in the hypertensive individuals. Compared with normotensive subjects, hypertensive patients had a 7/7-mm Hg greater fall in blood pressure (P<0.05 for systolic and P<0.01 for diastolic, adjusted for age), with similar changes in urinary sodium excretion. From the high-salt to low-salt diet, plasma renin activity rose from 0.90 to 5.99 ng · mL-1 · h-1 in normotensives, whereas in hypertensives it rose from 0.73 to only 3.14 ng · mL-1 · h-1 (P<0.05 between hypertensives and normotensives). Plasma aldosterone rose by 1396 pmol/L in normotensive subjects and by 511 pmol/L in hypertensive patients (P<0.05). Significant inverse correlations were obtained for all subjects between the fall in blood pressure from the high-salt to low-salt diet and the rise in plasma renin activity and aldosterone that occurred in addition to the absolute level on the low-salt diet. These results demonstrate that the larger fall in blood pressure with an acute reduction in salt intake in hypertensives compared with normotensives is, at least in part, due to a less-responsive renin-angiotensin-aldosterone system in the hypertensive patients.
Key Words: renin-angiotensin system • blood pressure • sodium • diet, sodium-restricted • hypertension, essential • normotension
This article has been cited by other articles:
 |
|
 |
|
  E. Ritz How Little Aldosterone is Able to Raise Blood Pressure? Clin. J. Am. Soc. Nephrol., April 1, 2009; 4(4): 703 - 710. [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 Authors/Task Force Members:, G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A. M. Heagerty, S. E. Kjeldsen, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Eur. Heart J., June 11, 2007; (2007) ehm236v1. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Franco and S. Oparil Salt sensitivity, a determinant of blood pressure, cardiovascular disease and survival. J. Am. Coll. Nutr., June 1, 2006; 25(3 Suppl): 247S - 255S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Appel, M. W. Brands, S. R. Daniels, N. Karanja, P. J. Elmer, and F. M. Sacks Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association Hypertension, February 1, 2006; 47(2): 296 - 308. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Meneton, X. Jeunemaitre, H. E. de Wardener, and G. A. Macgregor Links Between Dietary Salt Intake, Renal Salt Handling, Blood Pressure, and Cardiovascular Diseases Physiol Rev, April 1, 2005; 85(2): 679 - 715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Glorioso, F. Filigheddu, P. P. Parpaglia, A. Soro, C. Troffa, G. Argiolas, and P. Mulatero 11{beta}-Hydroxysteroid dehydrogenase type 2 activity is associated with left ventricular mass in essential hypertension Eur. Heart J., March 1, 2005; 26(5): 498 - 504. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. J. He, N. D. Markandu, G. A. Sagnella, H. E. de Wardener, and G. A. MacGregor Plasma Sodium: Ignored and Underestimated Hypertension, January 1, 2005; 45(1): 98 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. W. Jones Dietary Sodium and Blood Pressure Hypertension, May 1, 2004; 43(5): 932 - 935. [Full Text] [PDF]
|
|
|
|
 |
|
 T. W. Doulton and G. A MacGregor Review: Blood pressure in haemodialysis patients: The importance of the relationship between the renin-angiotensin-aldosterone system, salt intake and extracellular volume Journal of Renin-Angiotensin-Aldosterone System, March 1, 2004; 5(1): 14 - 22. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Manunta and G. Bianchi Low-Salt Diet and Diuretic Effect on Blood Pressure and Organ Damage J. Am. Soc. Nephrol., January 1, 2004; 15(90010): S43 - 46. [Abstract] [Full Text]
|
|
|
|
|
|
I. Narita, S. Goto, N. Saito, J. Song, J. Ajiro, F. Sato, D. Saga, D. Kondo, K. Akazawa, M. Sakatsume, et al. Interaction Between ACE and ADD1 Gene Polymorphisms in the Progression of IgA Nephropathy in Japanese Patients Hypertension, September 1, 2003; 42(3): 304 - 309. [Abstract] [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]
|
|
|
|
|
|
M. T. Sciarrone, P. Stella, C. Barlassina, P. Manunta, C. Lanzani, G. Bianchi, and D. Cusi ACE and {alpha}-Adducin Polymorphism as Markers of Individual Response to Diuretic Therapy Hypertension, March 1, 2003; 41(3): 398 - 403. [Abstract] [Full Text] [PDF]
|
|