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Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension: Results From a Randomized Trial

Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial Eduardo Pimenta ; Krishna K. Gaddam ; Suzanne Oparil ; Inmaculada Aban ; Saima Husain ; Louis J. Dell'Italia ; David A. Calhoun From the Endocrine Hypertension Research Centr... Full description

Journal Title: Hypertension 2009-09-01, Vol.54 (3), p.475-481
Main Author: Pimenta, Eduardo
Other Authors: Gaddam, Krishna K , Oparil, Suzanne , Aban, Inmaculada , Husain, Saima , Dell'Italia, Louis J , Calhoun, David A
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: Am Heart Assoc
ID: ISSN: 0194-911X
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2771382
title: Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension: Results From a Randomized Trial
format: Article
creator:
  • Pimenta, Eduardo
  • Gaddam, Krishna K
  • Oparil, Suzanne
  • Aban, Inmaculada
  • Husain, Saima
  • Dell'Italia, Louis J
  • Calhoun, David A
subjects:
  • Adult
  • Aged
  • Aldosterone - blood
  • Aldosterone - urine
  • Arterial hypertension. Arterial hypotension
  • Article
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • blood pressure
  • Blood Pressure - drug effects
  • Body Mass Index
  • Cardiology. Vascular system
  • Clinical manifestations. Epidemiology. Investigative techniques. Etiology
  • Creatinine - blood
  • Cross-Over Studies
  • diet
  • Diet, Sodium-Restricted
  • Dose-Response Relationship, Drug
  • Female
  • Heart Rate - drug effects
  • Humans
  • hypertension
  • Hypertension - blood
  • Hypertension - diet therapy
  • Hypertension - physiopathology
  • Male
  • Medical sciences
  • Middle Aged
  • Natriuretic Peptide, Brain - blood
  • Potassium - blood
  • Renin - blood
  • resistant hypertension
  • sodium
  • Sodium - urine
  • Sodium, Dietary - administration & dosage
  • Time Factors
ispartof: Hypertension, 2009-09-01, Vol.54 (3), p.475-481
description: Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial Eduardo Pimenta ; Krishna K. Gaddam ; Suzanne Oparil ; Inmaculada Aban ; Saima Husain ; Louis J. Dell'Italia ; David A. Calhoun From the Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders (E.P.), University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia; and the Vascular Biology and Hypertension Program (K.K.G., S.O., I.A., S.H., L.J.D., D.A.C.), University of Alabama at Birmingham. Correspondence to Eduardo Pimenta, MD, Hypertension Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia, 4102. E-mail e.pimenta{at}uq.edu.au Observational studies indicate a significant relation between dietary sodium and level of blood pressure. However, the role of salt sensitivity in the development of resistant hypertension is unknown. The present study examined the effects of dietary salt restriction on office and 24-hour ambulatory blood pressure in subjects with resistant hypertension. Twelve subjects with resistant hypertension entered into a randomized crossover evaluation of low (50 mmol/24 hours x 7 days) and high sodium diets (250 mmol/24 hours x 7 days) separated by a 2-week washout period. Brain natriuretic peptide; plasma renin activity; 24-hour urinary aldosterone, sodium, and potassium; 24-hour ambulatory blood pressure monitoring; aortic pulse wave velocity; and augmentation index were compared between dietary treatment periods. At baseline, subjects were on an average of 3.4±0.5 antihypertensive medications with a mean office BP of 145.8±10.8/83.9±11.2 mm Hg. Mean urinary sodium excretion was 46.1±26.8 versus 252.2±64.6 mmol/24 hours during low- versus high-salt intake. Low- compared to high-salt diet decreased office systolic and diastolic blood pressure by 22.7 and 9.1 mm Hg, respectively. Plasma renin activity increased whereas brain natriuretic peptide and creatinine clearance decreased during low-salt intake, indicative of intravascular volume reduction. These results indicate that excessive dietary sodium ingestion contributes importantly to resistance to antihypertensive treatment. Strategies to substantially reduce dietary salt intake should be part of the overall treatment of resistant hypertension. Key Words: blood pressure • hypertension • resistant hypertension • sodi
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleEffects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension: Results From a Randomized Trial
creatorPimenta, Eduardo ; Gaddam, Krishna K ; Oparil, Suzanne ; Aban, Inmaculada ; Husain, Saima ; Dell'Italia, Louis J ; Calhoun, David A
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descriptionEffects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial Eduardo Pimenta ; Krishna K. Gaddam ; Suzanne Oparil ; Inmaculada Aban ; Saima Husain ; Louis J. Dell'Italia ; David A. Calhoun From the Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders (E.P.), University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia; and the Vascular Biology and Hypertension Program (K.K.G., S.O., I.A., S.H., L.J.D., D.A.C.), University of Alabama at Birmingham. Correspondence to Eduardo Pimenta, MD, Hypertension Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia, 4102. E-mail e.pimenta{at}uq.edu.au Observational studies indicate a significant relation between dietary sodium and level of blood pressure. However, the role of salt sensitivity in the development of resistant hypertension is unknown. The present study examined the effects of dietary salt restriction on office and 24-hour ambulatory blood pressure in subjects with resistant hypertension. Twelve subjects with resistant hypertension entered into a randomized crossover evaluation of low (50 mmol/24 hours x 7 days) and high sodium diets (250 mmol/24 hours x 7 days) separated by a 2-week washout period. Brain natriuretic peptide; plasma renin activity; 24-hour urinary aldosterone, sodium, and potassium; 24-hour ambulatory blood pressure monitoring; aortic pulse wave velocity; and augmentation index were compared between dietary treatment periods. At baseline, subjects were on an average of 3.4±0.5 antihypertensive medications with a mean office BP of 145.8±10.8/83.9±11.2 mm Hg. Mean urinary sodium excretion was 46.1±26.8 versus 252.2±64.6 mmol/24 hours during low- versus high-salt intake. Low- compared to high-salt diet decreased office systolic and diastolic blood pressure by 22.7 and 9.1 mm Hg, respectively. Plasma renin activity increased whereas brain natriuretic peptide and creatinine clearance decreased during low-salt intake, indicative of intravascular volume reduction. These results indicate that excessive dietary sodium ingestion contributes importantly to resistance to antihypertensive treatment. Strategies to substantially reduce dietary salt intake should be part of the overall treatment of resistant hypertension. Key Words: blood pressure • hypertension • resistant hypertension • sodium • diet Related Article: Another Major Role for Dietary Sodium Reduction: Improving Blood Pressure Control in Patients With Resistant Hypertension Lawrence J. Appel Hypertension 2009 54: 444-446. [Extract] [Full Text] [PDF]
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subjectAdult ; Aged ; Aldosterone - blood ; Aldosterone - urine ; Arterial hypertension. Arterial hypotension ; Article ; Biological and medical sciences ; Blood and lymphatic vessels ; blood pressure ; Blood Pressure - drug effects ; Body Mass Index ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Creatinine - blood ; Cross-Over Studies ; diet ; Diet, Sodium-Restricted ; Dose-Response Relationship, Drug ; Female ; Heart Rate - drug effects ; Humans ; hypertension ; Hypertension - blood ; Hypertension - diet therapy ; Hypertension - physiopathology ; Male ; Medical sciences ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Potassium - blood ; Renin - blood ; resistant hypertension ; sodium ; Sodium - urine ; Sodium, Dietary - administration & dosage ; Time Factors
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descriptionEffects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial Eduardo Pimenta ; Krishna K. Gaddam ; Suzanne Oparil ; Inmaculada Aban ; Saima Husain ; Louis J. Dell'Italia ; David A. Calhoun From the Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders (E.P.), University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia; and the Vascular Biology and Hypertension Program (K.K.G., S.O., I.A., S.H., L.J.D., D.A.C.), University of Alabama at Birmingham. Correspondence to Eduardo Pimenta, MD, Hypertension Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia, 4102. E-mail e.pimenta{at}uq.edu.au Observational studies indicate a significant relation between dietary sodium and level of blood pressure. However, the role of salt sensitivity in the development of resistant hypertension is unknown. The present study examined the effects of dietary salt restriction on office and 24-hour ambulatory blood pressure in subjects with resistant hypertension. Twelve subjects with resistant hypertension entered into a randomized crossover evaluation of low (50 mmol/24 hours x 7 days) and high sodium diets (250 mmol/24 hours x 7 days) separated by a 2-week washout period. Brain natriuretic peptide; plasma renin activity; 24-hour urinary aldosterone, sodium, and potassium; 24-hour ambulatory blood pressure monitoring; aortic pulse wave velocity; and augmentation index were compared between dietary treatment periods. At baseline, subjects were on an average of 3.4±0.5 antihypertensive medications with a mean office BP of 145.8±10.8/83.9±11.2 mm Hg. Mean urinary sodium excretion was 46.1±26.8 versus 252.2±64.6 mmol/24 hours during low- versus high-salt intake. Low- compared to high-salt diet decreased office systolic and diastolic blood pressure by 22.7 and 9.1 mm Hg, respectively. Plasma renin activity increased whereas brain natriuretic peptide and creatinine clearance decreased during low-salt intake, indicative of intravascular volume reduction. These results indicate that excessive dietary sodium ingestion contributes importantly to resistance to antihypertensive treatment. Strategies to substantially reduce dietary salt intake should be part of the overall treatment of resistant hypertension. Key Words: blood pressure • hypertension • resistant hypertension • sodium • diet Related Article: Another Major Role for Dietary Sodium Reduction: Improving Blood Pressure Control in Patients With Resistant Hypertension Lawrence J. Appel Hypertension 2009 54: 444-446. [Extract] [Full Text] [PDF]
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titleEffects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension: Results From a Randomized Trial
authorPimenta, Eduardo ; Gaddam, Krishna K ; Oparil, Suzanne ; Aban, Inmaculada ; Husain, Saima ; Dell'Italia, Louis J ; Calhoun, David A
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abstractEffects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension Results From a Randomized Trial Eduardo Pimenta ; Krishna K. Gaddam ; Suzanne Oparil ; Inmaculada Aban ; Saima Husain ; Louis J. Dell'Italia ; David A. Calhoun From the Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders (E.P.), University of Queensland School of Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia; and the Vascular Biology and Hypertension Program (K.K.G., S.O., I.A., S.H., L.J.D., D.A.C.), University of Alabama at Birmingham. Correspondence to Eduardo Pimenta, MD, Hypertension Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia, 4102. E-mail e.pimenta{at}uq.edu.au Observational studies indicate a significant relation between dietary sodium and level of blood pressure. However, the role of salt sensitivity in the development of resistant hypertension is unknown. The present study examined the effects of dietary salt restriction on office and 24-hour ambulatory blood pressure in subjects with resistant hypertension. Twelve subjects with resistant hypertension entered into a randomized crossover evaluation of low (50 mmol/24 hours x 7 days) and high sodium diets (250 mmol/24 hours x 7 days) separated by a 2-week washout period. Brain natriuretic peptide; plasma renin activity; 24-hour urinary aldosterone, sodium, and potassium; 24-hour ambulatory blood pressure monitoring; aortic pulse wave velocity; and augmentation index were compared between dietary treatment periods. At baseline, subjects were on an average of 3.4±0.5 antihypertensive medications with a mean office BP of 145.8±10.8/83.9±11.2 mm Hg. Mean urinary sodium excretion was 46.1±26.8 versus 252.2±64.6 mmol/24 hours during low- versus high-salt intake. Low- compared to high-salt diet decreased office systolic and diastolic blood pressure by 22.7 and 9.1 mm Hg, respectively. Plasma renin activity increased whereas brain natriuretic peptide and creatinine clearance decreased during low-salt intake, indicative of intravascular volume reduction. These results indicate that excessive dietary sodium ingestion contributes importantly to resistance to antihypertensive treatment. Strategies to substantially reduce dietary salt intake should be part of the overall treatment of resistant hypertension. Key Words: blood pressure • hypertension • resistant hypertension • sodium • diet Related Article: Another Major Role for Dietary Sodium Reduction: Improving Blood Pressure Control in Patients With Resistant Hypertension Lawrence J. Appel Hypertension 2009 54: 444-446. [Extract] [Full Text] [PDF]
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