scholarly journals Paradoxical increase of 24-hour urinary aldosterone levels in obese patients with resistant hypertension on a high salt diet

2020 ◽  
Author(s):  
Tanja Dudenbostel ◽  
Peng Li ◽  
David A Calhoun
Keyword(s):  
Resistant Hypertension ◽  
Salt Intake ◽  
Sodium Intake ◽  
Normal Weight ◽  
High Salt ◽  
Dietary Sodium ◽  
Obese Patients ◽  
Dietary Salt ◽  
Antihypertensive Medications ◽  
Plasma Aldosterone Concentration

Abstract Background Having previously reported that aldosterone levels increase progressively with body mass index (BMI), the current analysis was done to determine to what extent this association is related to dietary high salt (HS) intake. We anticipated that aldosterone levels would decrease with higher sodium status consistent with classical suppression of aldosterone release secondary to progressive fluid retention induced by high dietary sodium intake. Methods Cross-sectional analysis of a large diverse cohort of 2705 patients with resistant hypertension (HTN) seen in a referral HTN Clinic. Dietary sodium intake was indexed by 24-hour (h) urinary sodium (UNa), aldosterone status was determined by plasma aldosterone concentration, plasma renin activity, and 24h urinary aldosterone (UAldo). Patients with normal weight served as control. Results In this study, 1572 individuals with complete 24 h urine collections were analyzed. Mean BMI was 32.5±7.1 kg/m 2 and ranged from 24.6±2.4 kg/m 2 (1st quartile) to 41.0±4.2 kg/m2 (4th quartile). BMI was positively associated with 24h UNa and UAldo levels (p<0.0001), 24h UNa and UAldo. There was a positively stronger correlation in obese (r=0.273, p<0.0001) compared to normal weight individuals (r=0.108, p=0.0342) independent of number and classes of antihypertensive medications. Conclusion Our analysis shows that there is an altered regulation of aldosterone in obese patients in the setting of high dietary salt intake.

scholarly journals Sodium Intake and Hypertension

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1970 ◽  
Author(s):  
Grillo ◽  
Salvi ◽  
Coruzzi ◽  
Salvi ◽  
Parati
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Sodium Intake ◽  
Peripheral Resistance ◽  
Dietary Sodium ◽  
Dietary Salt ◽  
High Sodium ◽  
Close Relationship ◽  
And Function ◽  
Modest Reduction

The close relationship between hypertension and dietary sodium intake is widely recognized and supported by several studies. A reduction in dietary sodium not only decreases the blood pressure and the incidence of hypertension, but is also associated with a reduction in morbidity and mortality from cardiovascular diseases. Prolonged modest reduction in salt intake induces a relevant fall in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group, with larger falls in systolic blood pressure for larger reductions in dietary salt. The high sodium intake and the increase in blood pressure levels are related to water retention, increase in systemic peripheral resistance, alterations in the endothelial function, changes in the structure and function of large elastic arteries, modification in sympathetic activity, and in the autonomic neuronal modulation of the cardiovascular system. In this review, we have focused on the effects of sodium intake on vascular hemodynamics and their implication in the pathogenesis of hypertension.

scholarly journals Genetically, dietary sodium intake is causally associated with salt-sensitive hypertension risk in a community-based cohort study: a Mendelian randomization approach

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.R Choi
Keyword(s):  
Mendelian Randomization ◽  
Salt Intake ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Funding Source ◽  
Dietary Salt ◽  
Community Based ◽  
Dietary Salt Intake ◽  
Hypertension Risk ◽  
Salt Sensitive Hypertension

Abstract   Excessive dietary salt intake is associated with an increased risk of hypertension. Salt sensitivity, i.e., an elevation in blood pressure in response to high dietary salt intake, has been associated with a high risk of cardiovascular disease and mortality. We investigated whether a causal association exists between dietary sodium intake and hypertension risk using Mendelian randomization (MR). We performed an MR study using data from a large genome-wide association study comprising 15,034 Korean adults in a community-based cohort study. A total of 1,282 candidate single nucleotide polymorphisms associated with dietary sodium intake, such as rs2960306, rs4343, and rs1937671, were selected as instrumental variables. The inverse variance weighted method was used to assess the evidence for causality. Higher dietary sodium intake was associated with salt-sensitive hypertension risk. The variants of SLC8E1 rs2241543 and ADD1 rs16843589 were strongly associated with increased blood pressure. In the logistic regression model, after adjusting for age, gender, smoking, drinking, exercise, and body mass index, the GRK4 rs2960306TT genotype was inversely associated with hypertension risk (OR = 0.356, 95% CI = 0.236–0.476). However, the 2350GG genotype (ACE rs4343) exhibited a 2.11-fold increased hypertension risk (OR = 2.114, 95% CI = 2.004–2.224) relative to carriers of the 2350AA genotype, after adjusting for confounders. MR analysis revealed that the odds ratio for hypertension per 1 mg/day increment of dietary sodium intake was 2.24 in participants with the PRKG1 rs12414562 AA genotype. Our findings suggest that dietary sodium intake may be causally associated with hypertension risk. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (2017R1D1A3B03034119, 2014M3C9A3064552), and the KRIBB Initiative program. This research was also supported by the Medical Research Center Program (2017R1A5A2015369). This work was supported (in part) by the Yonsei University Research Fund 2017. Bioresources for this study were provided by the National Biobank of Korea and the Centers for Disease Control and Prevention, Republic of Korea (2017-009).

Renal denervation chronically lowers arterial pressure independent of dietary sodium intake in normal rats

2003 ◽  
Vol 284 (6) ◽  
pp. H2302-H2310 ◽  
Author(s):  
Frédéric Jacob ◽  
Pilar Ariza ◽  
John W. Osborn
Keyword(s):  
Arterial Pressure ◽  
Salt Intake ◽  
Sodium Intake ◽  
Recovery Period ◽  
Control Period ◽  
Dietary Sodium ◽  
Renal Nerves ◽  
Dietary Salt ◽  
Dietary Salt Intake ◽  
High Salt Intake

The present study was designed to test the hypothesis that renal nerves chronically modulate arterial pressure (AP) under basal conditions and during changes in dietary salt intake. To test this hypothesis, continuous telemetric recording of AP in intact (sham) and renal denervated (RDNX) Sprague-Dawley rats was performed and the effect of increasing and decreasing dietary salt intake on AP was determined. In protocol 1, 24-h AP, sodium, and water balances were measured in RDNX ( n = 11) and sham ( n = 9) rats during 5 days of normal (0.4% NaCl) and 10 days of high (4.0% NaCl) salt intake, followed by a 3-day recovery period (0.4% NaCl). Protocol 2 was similar with the exception that salt intake was decreased to 0.04% NaCl for 10 days after the 5-day period of normal salt (0.04% NaCl) intake (RDNX; n = 6, sham; n = 5). In protocol 1, AP was lower in RDNX (91 ± 1 mmHg) compared with sham (101 ± 2 mmHg) rats during the 5-day 0.4% NaCl control period. During the 10 days of high salt intake, AP increased <5 mmHg in both groups so that the difference between sham and RDNX rats remained constant. In protocol 2, AP was also lower in RDNX (93 ± 2 mmHg) compared with sham (105 ± 4 mmHg) rats during the 5-day 0.4% NaCl control period, and AP did not change in response to 10 days of a low-salt diet in either group. Overall, there were no between-group differences in sodium or water balance in either protocol. We conclude that renal nerves support basal levels of AP, irrespective of dietary sodium intake in normal rats.

scholarly journals Rationale, protocol and baseline characteristics of the metabolome, microbiome, and dietary salt intervention study (MetaSalt)

2021 ◽  
Author(s):  
Zengliang Ruan ◽  
Jianxin Li ◽  
Fangchao Liu ◽  
Jie Cao ◽  
Shufeng Chen ◽  
...  
Keyword(s):  
Intervention Study ◽  
Dietary Intervention ◽  
Sodium Intake ◽  
Northern China ◽  
High Salt ◽  
Dietary Sodium ◽  
Dietary Salt ◽  
High Sodium ◽  
Low Salt ◽  
Family Based

AbstractHigh sodium intake has been recognized as an important risk factor for hypertension, but the role of gut microbiota composition and metabolomic profiles in the association between dietary sodium intake and blood pressure (BP) is uncertain. The metabolome, microbiome, and dietary salt intervention study (MetaSalt) study was conducted to investigate whether low- and high-dietary sodium intake influences BP by changing the microbial and metabolomic profiles. This is a family-based, multicentre intervention study conducted in four rural field-centres across three provinces in rural Northern China. Probands with untreated prehypertension or stage-1 hypertension were identified through a community-based BP screening, and their family members included siblings, offspring, spouses and parents were subsequently included. During the dietary intervention, low-salt and high-salt diets were provided free of charge to all participants. A total of 529 participants in four field centres were included in our study, with a mean age of 48.1 years old, and about 36.7% of them were male, 76.5% had a middle school (69.5%) or higher (7.0%) diploma, 23.4% had a history of smoke, 24.4% were current drinkers. The mean systolic and diastolic BP levels in the baseline were 129.54 mm Hg and 81.02 mm Hg for all participants, and significantly decreased during the low-salt intervention and increased during the high-salt intervention. Our study is well placed to check the impacts of dietary sodium intake on microbial and metabolomic profiles, which will have important implications for discovering the mechanisms in the development of hypertension and subsequent cardiovascular disease.

Abstract P421: Estimation Of Adult Dietary Sodium Intake And Source In Shandong China 2011: Finding From SMASH Project Baseline Survey

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Liuxia YAN ◽  
Zilong LU ◽  
Jixiang MA ◽  
Xiaolei GUO ◽  
Jiyu ZHANG ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Monosodium Glutamate ◽  
Soy Sauce ◽  
Dietary Sodium ◽  
Baseline Survey ◽  
Dietary Salt ◽  
Ministry Of Health ◽  
Cross Sectional ◽  
Dietary Recall

Zilong LU, Liuxia YAN, Jixiang MA, Xiaolei GUO, Jiyu ZHANG, Junli TANG, Huicheng WANG, Xiaoning CAI Background: Moderate population salt reduction could reduce blood pressure and the cardiovascular and stroke mortality in the long-term. In 2002, China’s national average dietary salt intake is twice of the recommendation sodium intake limit by Chinese Nutrition Association. To tackle the health burden of excessive salt intake, the former Ministry of Health has chosen Shandong province as national pilot and launched the Shandong & Ministry of Health Action on Salt and Hypertension (SMASH, 2011[[Unable to Display Character: &#8211;]]2015) project. Objective: To develop and target intervention priority, a cross-sectional population survey was conducted to collect baseline data on sodium intake and sources in Shandong adults in 2011. Methods: We used multi-stage clustering sampling method to select the provincial representative sample for Shandong adults aged 18~69 years old. The selected adults were invited to participate the questionnaire survey and consecutive three-round 24-hour dietary recall. The Chinese 24-hour dietary recall includes two parts, cooking condiment weighting and the food (exclude the condiment) intake diary. The sodium contents in the condiments and food were calculated by using reference values from China Food Composition 2004. Results: Overall, 2140 community adult residents were included in the data analysis. The total average dietary sodium intake estimated by 24-hour dietary recall was 5745mg (95%CI: 5428-6063). Men (6147mg/d, 5824-6471) consumed higher sodium than women (5339 mg/d, 5006-5673) (P<0.05). The majority of dietary sodium (81%) was from cooking condiments including salt, soy sauce, sauce and monosodium glutamate (MSG), with a mean sodium intake of 4640mg (4360-4920). Out of the cooking condiments, salt added during food preparation was the leading source (63%) of sodium intake, up to 3638mg/d (3397-3879) sodium intake. Sodium intake from processed food was account for 10% of the total sodium intake, averaged at 582 mg (498-666) sodium intake for Shandong adults. Conclusion: The Shandong adults consume excessive sodium than the recommendation intake and most is from the condiments added at cooking.

scholarly journals Enhancement of Neural Salty Preference in Obesity

2017 ◽  
Vol 43 (5) ◽  
pp. 1987-2000 ◽  
Author(s):  
Qiang Li ◽  
Rongbing Jin ◽  
Hao Yu ◽  
Hongmei Lang ◽  
Yuanting Cui ◽  
...  
Keyword(s):  
Local Community ◽  
Salt Intake ◽  
Random Order ◽  
Brain Regions ◽  
Normal Weight ◽  
Salt Sensitivity ◽  
High Salt ◽  
Dietary Salt ◽  
Double Blind ◽  
High Salt Intake

Background/Aims: Obesity and high salt intake are major risk factors for hypertension and cardiometabolic diseases. Obese individuals often consume more dietary salt. We aim to examine the neurophysiologic effects underlying obesity-related high salt intake. Methods: A multi-center, random-order, double-blind taste study, SATIETY-1, was conducted in the communities of four cities in China; and an interventional study was also performed in the local community of Chongqing, using brain positron emission tomography/computed tomography (PET/CT) scanning. Results: We showed that overweight/obese individuals were prone to consume a higher daily salt intake (2.0 g/day higher compared with normal weight individuals after multivariable adjustment, 95% CI, 1.2-2.8 g/day, P < 0.001), furthermore they exhibited reduced salt sensitivity and a higher salt preference. The altered salty taste and salty preference in the overweight/obese individuals was related to increased activity in brain regions that included the orbitofrontal cortex (OFC, r = 0.44, P= 0.01), insula (r = 0.38, P= 0.03), and parahippocampus (r = 0.37, P= 0.04). Conclusion: Increased salt intake among overweight/obese individuals is associated with altered salt sensitivity and preference that related to the abnormal activity of gustatory cortex. This study provides insights for reducing salt intake by modifying neural processing of salty preference in obesity.

Immunoreactive Substance P in Human Plasma: Response to Changes in Posture and Sodium Balance

1980 ◽  
Vol 59 (1) ◽  
pp. 75-77 ◽  
Author(s):  
H. J. Kramer ◽  
R. Düsing ◽  
H. Stelkens ◽  
R. Heinrich ◽  
J. Kipnowski ◽  
...  
Keyword(s):  
Substance P ◽  
Salt Intake ◽  
Sodium Intake ◽  
Plasma Concentrations ◽  
Mean Value ◽  
Dietary Sodium ◽  
Sodium Balance ◽  
Dietary Salt ◽  
Dietary Salt Intake ◽  
High Sodium

1. In healthy volunteers plasma concentrations of immunoreactive substance P were measured in response to changes in posture and dietary salt intake. 2. In 14 subjects plasma immunoreactive substance P was 168 ± 31 pmol/l when subjects were supine and 401 ± 51 pmol/l (P < 0.001) when they were ambulant. 3. Measurement of supine plasma immunoreactive substance P at 6 h intervals gave a mean value of 240 ± 39 pmol/l at 14.00 hours and a lowest value of 76 ± 9 pmol/l at 02.00 hours. 4. In eight healthy subjects plasma immunoreactive substance P rose only slightly from 169 ± 41 pmol/l, on a sodium intake ad lib., to 244 ± 45 pmol/l by day 4 of dietary sodium restriction (35 mmol/day) and significantly fell to 51 ± 20 pmol/l (P < 0.001) by day 4 of high sodium intake (350 mmol/day). 5. Although exogenous substance P was shown to be natriuretic in dog and rat, the present results do not favour a role of endogenous substance P as a circulating natriuretic factor in man.

Clearance of endogenous lithium in humans: altered dietary salt intake and comparison with exogenous lithium clearance

1995 ◽  
Vol 268 (4) ◽  
pp. F718-F722 ◽  
Author(s):  
E. Folkerd ◽  
D. R. Singer ◽  
F. P. Cappuccio ◽  
N. D. Markandu ◽  
B. Sampson ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Lithium Concentration ◽  
Fractional Excretion ◽  
Dietary Sodium ◽  
Lithium Clearance ◽  
Dietary Salt ◽  
Renal Handling ◽  
Dietary Salt Intake ◽  
High Sodium

We compared endogenous with exogenous lithium clearance (CLi) and studied the effects of dietary salt intake on endogenous CLi in healthy volunteers. Lithium was detectable within a narrow fourfold range in serum and in urine in all 25 subjects studied [serum (n = 25), mean 0.27 +/- 0.02 mumol/l, range 0.13-0.55 mumol/l; urine (n = 20), range 1.49–7.32, mean 4.09 +/- 0.36 mumol/24 h]. Mean clearance and fractional excretion of endogenous lithium were lower (15.2 +/- 2.0 ml/min and 16.4 +/- 2.1%, respectively) compared with results obtained using the exogenous CLi technique (25.5 +/- 1.7 ml/min and 27.9 +/- 2.1%; P < 0.01 and P < 0.05, respectively; n = 17). In a separate group of six normal subjects, absolute (8.7 +/- 2.9 vs. 20.7 +/- 3.8 ml/min) and fractional excretion of lithium (8.3 +/- 2.9 vs. 18.0 +/- 5.1%) were significantly lower on 5 days of low (31 +/- 10 mmol/day) vs. high sodium intake (357 +/- 78 mmol/day; P < 0.05). Use of endogenous CLi precludes the need for lithium tablets. This could be a particular advantage in population studies and permits serial measurement of CLi on different days. Our results show that it is important to take dietary sodium intake into account in studies of endogenous CLi. Lower values for endogenous compared with exogenous CLi could reflect differences in renal handling depending on the plasma lithium concentration. This clearly requires further study.

scholarly journals High-Salt Diet Accelerated the Decline of Residual Renal Function in Patients With Peritoneal Dialysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Nirong Gong ◽  
Chun Zhou ◽  
Jianxia Hu ◽  
Xiaohong Zhong ◽  
Zhixiu Yi ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Residual Renal Function ◽  
High Salt ◽  
Dietary Sodium ◽  
High Salt Intake

Objective: This study aims to investigate the relationship between dietary salt intake and residual renal function in peritoneal dialysis (PD) patients.Methods: The daily salt intake of the patients was calculated based on a 3 day dietary record. Sixty-two patients were divided into three groups: 33 patients in the low salt intake group (salt intake &lt;6.0 g/day), 17 in the medium salt intake group (salt intake 6.0 to &lt;8.0 g/day), and 12 in the high salt intake group (salt intake ≥8.0 g/day). Regular follow-up was conducted every 3 months. Urine volume, peritoneal ultrafiltration volume, and other clinical indicators were recorded. Biochemical indexes were detected to evaluate the changes in residual renal function and peritoneal function during follow-up.Results: A positive correlation between dietary sodium intake and sodium excretion was found. During 12-month follow-up, a decrease of residual renal function showed a significant difference among the three groups (p = 0.041) (15.3 ± 27.5 vs. 12.5 ± 11.5 vs. 32.9 ± 18.4 L/W/1.73 m2 in the low-, medium-, and high salt intake groups, respectively). Consistently, a higher decline of residual renal function (adjusted β, 20.37; 95% CI, 2.83, 37.91) was found in participants with high salt intake (salt intake ≥8 g/day) compared with those in non-high salt intake.Conclusion: Our study showed that the sodium excretion by peritoneal dialysis was positively correlated with dietary sodium intake in PD patients. The high salt intake diet (salt intake ≥8 g/day) may lead to a faster decline of residual renal function in PD patients.

scholarly journals Non-uniform relationship between salt status and aldosterone activity in patients with chronic kidney disease

2018 ◽  
Vol 132 (2) ◽  
pp. 285-294 ◽  
Author(s):  
Alison H.M. Taylor ◽  
Alastair J. Rankin ◽  
Emily P. McQuarrie ◽  
E. Marie Freel ◽  
Natalie Z.M. Homer ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Angiotensin Ii ◽  
Kidney Disease ◽  
Salt Intake ◽  
High Salt ◽  
Dietary Salt ◽  
Plasma Aldosterone Concentration ◽  
Salt Loading ◽  
Salt Diet ◽  
Intravenous Saline

Background: Hypertension is prevalent in chronic kidney disease (CKD). Studies suggest that reduction in dietary salt intake reduces blood pressure (BP). We studied relationships between salt intake, BP and renin–angiotensin system regulation in order to establish if it is disordered in CKD. Methods: Mechanistic crossover study of CKD patients versus non-CKD controls. Participants underwent modified saline suppression test prior to randomization to either low or high salt diet for 5 days and then crossed over to the alternate diet. Angiotensin-II stimulation testing was performed in both salt states. BP, urea and electrolytes, and plasma aldosterone concentration (PAC) were measured. Results: Twenty-seven subjects were recruited (12 CKD, 15 control). There was no difference in age and baseline BP between the groups. Following administration of intravenous saline, systolic BP increased in CKD but not controls (131 ± 16 to 139 ± 14 mmHg, P=0.016 vs 125 ± 20 to 128 ± 22 mmHg, P=0.38). Median PAC reduced from 184 (124,340) to 95 (80,167) pmol in controls (P=0.003), but failed to suppress in CKD (230 (137,334) to 222 (147,326) pmol (P=0.17)). Following dietary salt modification, there was no change in BP in either group. Median PAC was lower following high salt compared with low salt diet in CKD and controls. There was a comparable increase in systolic BP in response to angiotensin-II in both groups. Discussion: We demonstrate dysregulation of aldosterone in CKD in response to salt loading with intravenous saline, but not to dietary salt modification.

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