Dietary Sodium Restriction Restores Nocturnal Reduction of Blood Pressure in Patients with Primary Aldosteronism.

DOI PubMed 被引用文献9件 参考文献44件
  • TAKAKUWA Hiroshi
    Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Science
  • SHIMIZU Kazuaki
    Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Science
  • IZUMIYA Yoshiaki
    Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Science
  • KATO Tamayo
    Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Science
  • NAKAYA Izaya
    Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Science
  • YOKOYAMA Hitoshi
    Division of Blood Purification, Kanazawa University Hospital
  • KOBAYASHI Ken-ichi
    Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Science
  • ISE Takuyuki
    National Kanazawa Hospital

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The purpose of this study was to elucidate the effects of dietary sodium restriction on diurnal blood pressure (BP) variation in primary aldosteronism. We studied the diurnal variation in the systemic hemodynamic indices and in baroreflex sensitivity (BRS). In 13 subjects with aldosterone-producing adenomas (2 males; mean age, 39±2 years), intra-arterial pressure was monitored telemetrically on a normal salt diet (NaCl 10-12 g/day). Non-dippers were defined as those with a nocturnal reduction in systolic BP (SBP) of less than 10% of daytime SBP. Ten subjects showed a non-dipper pattern. Six of these “non-dippers” underwent repetitive hemodynamic studies on the last day of a 1-week low salt diet regimen (NaCl 2-4 g/day). Stroke volume was determined using Wesseling’s pulse contour method, calibrated with indocyanine green dilution. BRS was calculated every 30 min as Δpulse interval/ΔSBP on spontaneous variations. Nocturnal reduction of SBP was 4.1% on the normal salt diet. With sodium restriction, urinary sodium excretion decreased from 187±8 to 46±8 mmol/day, and body weight decreased from 57.9±2.1 to 56.6±1.9 kg. Nighttime BP significantly decreased with dietary modification from 154±7/88±4 to 140±6/78±4 mmHg, whereas daytime BP was unaltered. With sodium restriction, cardiac index and stroke index decreased throughout the day. No significant difference was seen in either daytime or nighttime BRS between the two diets. We conclude that the non-dipper pattern is common in patients with an aldosterone-producing adenoma on a normal salt intake, and under such conditions, volume expansion appears to play a major role in the impairment of nocturnal BP reduction. (Hypertens Res 2002; 25: 737-742)

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