Dietary sodium restriction reduces blood pressure in patients with treatment resistant hypertension

BMC Nephrology

Research

Nikolai Hoffmann-Petersen¹  Thomas Guldager Lauridsen¹  Bodil G. Hornstrup²  Jesper N. Bech² 

[1] University Clinic in Nephrology and Hypertension, Gødstrup Hospital and Aarhus University, Hospitalsparken 15, DK-7400, Herning, Denmark;University Clinic in Nephrology and Hypertension, Gødstrup Hospital and Aarhus University, Hospitalsparken 15, DK-7400, Herning, Denmark;Department of Medicine, Gødstrup Hospital, Herning, Denmark;

关键词: Ambulatory blood pressure monitoring;    Dietary sodium restriction;    Sodium sensitivity;    Endothelial function;   

DOI  :  10.1186/s12882-023-03333-9

 received in 2023-07-07, accepted in 2023-09-14,  发布年份 2023

来源: Springer

【 摘 要 】

PurposePatients with treatment resistant hypertension (TRH) are at particular risk of cardiovascular disease. Life style modification, including sodium restriction, is an important part of the treatment of these patients. We aimed to analyse if self-performed dietary sodium restriction could be implemented in patients with TRH and to evaluate the effect of this intervention on blood pressure (BP). Moreover, we aimed to examine if mechanisms involving nitric oxide, body water content and BNP, renal function and handling of sodium were involved in the effect on nocturnal and 24-h BP. Also, measurement of erythrocyte sodium sensitivity was included as a possible predictor for the effect of sodium restriction on BP levels.Patients and methodsTRH patients were included for this interventional four week study: two weeks on usual diet and two weeks on self-performed sodium restricted diet with supplementary handed out sodium-free bread. At the end of each period, 24-h BP and 24-h urine collections (sodium, potassium, ENaC) were performed, blood samples (BNP, NOx, salt blood test) were drawn, and bio impedance measurements were made.ResultsFifteen patients, 11 males, with a mean age of 59 years were included. After sodium restriction, urinary sodium excretion decreased from 186 (70) to 91 [51] mmol/24-h, and all but one reduced sodium excretion. Nocturnal and 24-h systolic BP were significantly reduced (− 8 and − 10 mmHg, respectively, p < 0.05). NOx increased, BNP and extracellular water content decreased, all significantly. Change in NOx correlated to the change in 24-h systolic BP. BP response after sodium restriction was not related to sodium sensitivity examined by salt blood test.ConclusionSelf-performed dietary sodium restriction was feasible in a population of patients with TRH, and BP was significantly reduced. Increased NOx synthesis may be involved in the BP lowering effect of sodium restriction.Trial registrationThe study was registered in Clinical trials with ID: NCT06022133.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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