Published online before print December 17, 2007, doi: 10.1161/HYPERTENSIONAHA.107.100701
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 2008;51:339.)
© 2008 American Heart Association, Inc.
Original Articles |
Relation of Dietary Salt and Aldosterone to Urinary Protein Excretion in Subjects With Resistant Hypertension
From the Vascular Biology and Hypertension Program, University of Alabama at Birmingham.
Correspondence to Eduardo Pimenta, 933 19th St South, Room 115, Birmingham, AL 35294. E-mail eduardo.pimenta{at}ccc.uab.edu
Experimental data indicate that the cardiorenal effects of aldosterone excess are dependent on concomitant high dietary salt intake. Such an interaction of endogenous aldosterone and dietary salt has not been observed previously in humans. We assessed the hypothesis that excess aldosterone and high dietary sodium intake combine to worsen proteinuria in patients with resistant hypertension. Consecutive subjects with resistant hypertension (n=84) were prospectively evaluated by measurement of 24-hour urinary aldosterone (Ualdo), sodium, and protein (Uprot) excretion. Subjects were analyzed according to aldosterone status (high: Ualdo 
12 µg/24 hours; or normal: <12 µg/24 hours) and dietary salt intake based on tertiles of urinary sodium. The mean clinic blood pressure for all of the subjects was 161.4±22.4/89.8±13.5 mm Hg on an average of 4.3 medications. There was no blood pressure difference between study groups. Uprot was significantly higher in the 38 subjects with high Ualdo compared with the 46 subjects with normal Ualdo (143.0±83.8 versus 95.9±81.7 mg/24 hours; P=0.01). Among subjects with high Ualdo, Uprot increased progressively across urinary sodium groups (P<0.05). In contrast, there was no difference in Uprot across sodium tertiles among subjects with normal Ualdo. A positive correlation between Uprot and urinary sodium (r=0.47; P=0.003) was observed in subjects with high Ualdo but not in subjects with normal Ualdo (r=0.18; P value not significant). These results suggest that aldosterone excess and high dietary salt combine to increase urinary protein excretion.
Key Words: hypertension • aldosterone • salt • proteinuria • kidney
This article has been cited by other articles:
 |
|
 |
|
  E M Freel, I K Tsorlalis, J D Lewsey, R Latini, A P Maggioni, S Solomon, B Pitt, J M C Connell, and J J V McMurray Aldosterone status associated with insulin resistance in patients with heart failure--data from the ALOFT study Heart, December 1, 2009; 95(23): 1920 - 1924. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Pimenta, K. K. Gaddam, S. Oparil, I. Aban, S. Husain, L. J. Dell'Italia, and D. A. Calhoun Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension: Results From a Randomized Trial Hypertension, September 1, 2009; 54(3): 475 - 481. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ritz and A. Tomaschitz Aldosterone, a vasculotoxic agent--novel functions for an old hormone Nephrol. Dial. Transplant., August 1, 2009; 24(8): 2302 - 2305. [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. Sanders Vascular consequences of dietary salt intake Am J Physiol Renal Physiol, August 1, 2009; 297(2): F237 - F243. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Sowers, A. Whaley-Connell, and M. Epstein Narrative Review: The Emerging Clinical Implications of the Role of Aldosterone in the Metabolic Syndrome and Resistant Hypertension Ann Intern Med, June 2, 2009; 150(11): 776 - 783. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W. Sanders Dietary Salt Intake, Salt Sensitivity, and Cardiovascular Health Hypertension, March 1, 2009; 53(3): 442 - 445. [Full Text] [PDF]
|
|