on September 16, 2002
Published online before print September 16, 2002, doi: 10.1161/01.CIR.0000033519.45615.C7
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on May 17, 2002
From Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Centro Interuniversitario di Fisiologia Clinica e Ipertensione and Istituto Auxologico Italiano, Milan, Italy. * To whom correspondence should be addressed. E-mail: giuseppe.mancia{at}unimib.it.
Background—In essential hypertension, marked restrictions in dietary sodium intake cause in the short-term period an increase in muscle sympathetic nerve traffic (MSNA) and a baroreflex impairment. The present study was set out to assess on a long-term basis the neuroadrenergic and reflex effects of moderate sodium restriction. Methods and Results—In 11 untreated mild to moderate essential hypertensive patients (age 42.0±2.6 years, mean±SEM), we measured beat-to-beat blood pressure (Finapres), heart rate (ECG), and MSNA (microneurography) at rest and during stepwise intravenous infusions of phenylephrine and nitroprusside. Measurements were performed at regular sodium intake, after 1 and 8 weeks of low-sodium diet (80 mmol NaCl/d), and repeated again at regular sodium intake. After 1 week, urinary sodium excretion was markedly reduced. This was accompanied by a slight blood pressure reduction, no heart rate change, and a significant increase in plasma renin activity, aldosterone, and MSNA (+23.0±4.6% P<0.05). Whereas baroreflex heart-rate control was unchanged, baroreflex modulation of MSNA was reduced by 46.8±5.1% (P<0.01). At the end of the 8-week low-sodium diet, the neurohumoral and baroreflex responses were similar to the ones observed after 1 week of the dietary intervention. All changes disappeared when regular sodium diet was restored. Conclusions—Thus, a moderate dietary sodium restriction triggers a sympathetic activation and a baroreflex impairment. Maintenance of low-sodium diet for several weeks does not attenuate these adverse adrenergic and reflex effects.
Revised on July 23, 2002
Accepted on July 23, 2002
Short- and Long-Term Neuroadrenergic Effects of Moderate Dietary Sodium Restriction in Essential Hypertension
Guido Grassi MD,
Key words: hypertension • sodium • nervous system, sympathetic • nervous system, autonomic • baroreceptors
This article has been cited by other articles:
 |
|
 |
|
  F. D. McBryde, S.-J. Guild, C. J. Barrett, J. W. Osborn, and S. C. Malpas Cardiovascular Control: Angiotensin II-based hypertension and the sympathetic nervous system: the role of dose and increased dietary salt in rabbits Exp Physiol, September 1, 2007; 92(5): 831 - 840. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members:, G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A. M. Heagerty, S. E. Kjeldsen, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Eur. Heart J., June 11, 2007; (2007) ehm236v1. [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Lely, J. A. Krikken, S. J. L. Bakker, F. Boomsma, R. P. F. Dullaart, B. H. R. Wolffenbuttel, and G. Navis Low Dietary Sodium and Exogenous Angiotensin II Infusion Decrease Plasma Adiponectin Concentrations in Healthy Men J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1821 - 1826. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H. Eisenach, D. R. Schroeder, T. L. Pike, C. P. Johnson, W. G. Schrage, E. M. Snyder, B. D. Johnson, V. D. Garovic, S. T. Turner, and M. J. Joyner Dietary sodium restriction and {beta}2-adrenergic receptor polymorphism modulate cardiovascular function in humans J. Physiol., August 1, 2006; 574(3): 955 - 965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. H. Alderman Evidence relating dietary sodium to cardiovascular disease. J. Am. Coll. Nutr., June 1, 2006; 25(3 Suppl): 256S - 261S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Damgaard, P. Norsk, F. Gustafsson, J. K. Kanters, N. J. Christensen, P. Bie, L. Friberg, and N. Gadsboll Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2006; 290(5): R1294 - R1301. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Coruzzi, G. Parati, L. Brambilla, V. Brambilla, M. Gualerzi, A. Novarini, P. Castiglioni, and M. Di Rienzo Effects of Salt Sensitivity on Neural Cardiovascular Regulation in Essential Hypertension Hypertension, December 1, 2005; 46(6): 1321 - 1326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q. Fu, R. Zhang, S. Witkowski, A. Arbab-Zadeh, A. Prasad, K. Okazaki, and B. D. Levine Persistent Sympathetic Activation During Chronic Antihypertensive Therapy: A Potential Mechanism for Long Term Morbidity? Hypertension, April 1, 2005; 45(4): 513 - 521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. H.H.T. Klein, G. Ligtenberg, J. Neumann, P. L. Oey, H. A. Koomans, and P. J. Blankestijn Sympathetic Nerve Activity Is Inappropriately Increased in Chronic Renal Disease J. Am. Soc. Nephrol., December 1, 2003; 14(12): 3239 - 3244. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. J. He, G. A. MacGregor, G. Grassi, G. Foglia, R. Dell'Oro, F. Quarti-Trevano, G. Seravalle, and G. Mancia Salt Intake and Sympathetic Activity * Response Circulation, April 29, 2003; 107 (16): e108 - e108. [Full Text] [PDF]
|
|