Correlation of Salt Sensitivity, Plasma Renin Activity and Aldosterone in Hypertensive Patients

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Plasma-renin values vary in normotensive and hypertensive populations. Some studies consider renin to be a key factor in the aetiology of hypertension, but other studies note that renin is an important factor in cardiovascular homeostasis and functions more as a growth factor than as a pressor hormone. The aim of this study was to assess the PRA and aldosterone values under different salt intake regimes in patients with essential hypertension. The study group consisted of 50 untreated patients (27 women and 23 men; average age 42±9,2 yrs.; average BMI 27,91±4,6 kg/m2) with essential hypertension. All patients were put on a high-sodium diet (200 mmol NaCl per day) for one week after a week on a low-sodium diet (20 mmol NaCl per day). Sodium sensitivity (SS) was defined as a 10-mmHg increase in the mean blood pressure at the end of the high- vs. the low-sodium diet. The SS group consisted of 26 patients, and the sodiuminsensitive group consisted of 24 patients. The PRA and aldosterone levels were determined in 12 patients. PRA values in the SS group during rest were significantly lower compared with the salt-resistant group during all regimes of salt intake (F=10,56, p=0,0012). Salt loading in SS patients causes a significant decrease in PRA (in rest and effort) values in comparison to values during a low salt intake regime (rest: t=4,49, p<0,001; effort: t=3,45, p<0,01). The PRA values in the salt-resistant group did not vary significantly under the different salt intake regimes. The aldosterone values followed the pattern of the PRA values. It is necessary to distinguish investigations on salt intake effects based on incidence and value of blood pressure and investigations on salt restriction’s effects on of blood pressure levels (i.e., non-pharmacological hypertension therapy).

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  • 1. Williams GH Dluhy RG Lifton RP Moore TJ Gleason R Williams R Hunt SC Hopkins PN Hollenberg NK. Non-modulation as an intermediate phenotype in essential hypertension. Hypertension. 1992 Dec;20(6):788-96.

  • 2. Sealey JE Blumenfeld JD Bell GM Pecker MS Sommers SC Laragh JH. On the renal basis of essential hypertension. Nephron heterogeneity with discordant renin secretion and sodium excretion causing a hypertensive vasoconstriction-volume relationship. Kidney Int 1988;34(Supp1 25):S64-S7.

  • 3. Gaboury CL Simonson DC Seely EW Hollenberg NK and Williams GH. Relation of pressor responsiveness to angiotensin II and insulin resistance in hypertension. J Clin Invest. Dec 1994; 94(6): 2295-2300.

  • 4. Sahay M and Sahay RK. Low renin hypertension. Indian J Endocrinol Metab. 2012 Sep-Oct; 16(5): 728-739.

  • 5. Alderman MH Madhavan S Ooi WL Cohen H Sealey JE Laragh JH. Association of the renin-sodium profile with the risk of myocardial infarction in patients with hypertension. N Engl J Med 1991;324:1098-1104.

  • 6. Alderman MH Laragh JH and Sealey. JE. More about plasma renin and cardiovascular Mortality. European Heart Journal. 2011 doi:

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  • 7. Wyndham RN Gimenez L Walker WG Whelton PK Russell RP. Influence of renin levels on the treatment of essential hypertension with thiazide diuretics. Arch Intern Med. 1987. 147(6):1021-5.

  • 8. Laragh JH. Laragh’s Lessons in Renin System Pathophysiology for Treating Hypertension and its Fatal Cardiovascular onsequences. New York: Elseivier Science Inc. 2003.

  • 9. Laragh JH. Vasoconstriction-volume analysis for understanding and treating hypertension: the use of renin and aldosterone profiles. Am J Med 1973;55:261-274.

  • 10. Kawasaki T. Delea C.S. Bartter F.C. Smith H. The effect of high-sodium and low- sodium intakes on blood pressure and other related variables in human subjects with idiopathic hypertension. Am J Med. 1978; 64: 193-8.

  • 11. Weinberger MH. Salt Sensitivity of Blood Pressure in Humans. Hypertension. 1996; 27: 481-490.

  • 12. Sullivan JM. Salt sensitivity. Definition conception methodology and long-term issues. Hypertension. 1991 Jan;17(1 Suppl):I61-8.

  • 13. B. Wedler M. Wiersbitzki S. Gruska E. Wolf and F. C. Luft. Definitions and Characteristics of Salt-sensitivity and Resistance of Blood Pressure: Should the Diagnosis Depend on Diastolic Blood Pressure? Clinical and experimental hypertension1992. 14(6): 1037-1049.

  • 14. Resnick L.M. Muller F.B. Laragh J.H. Calcium-regulation hormones in essential hypertension: relation to plasma renin activity and sodium metabolism. Ann Intern Med 1986; 105: 649-54.

  • 15. Resnick L.M. Nicholson J.P. Laragh J.H. Calcium metabolim in essential hypertension: relationship to altered renin system activity. Federation proceedings 1986; Vol. 45 No. 12; November: 2739-2744.

  • 16. MacGregor G.A. Markandu N.D. Sagnella G.A. Singer D.R.J. Cappuccio F.P. Double-blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension. Lancet 1989; ii: 1244-1247.

  • 17. Resnick L.M. Calciotropic hormones in salt-sensitive essential hypertension: 125-dihydroxyvitamin D and parathyroid hypertensive factor. Journal of Hypertension 1994; Vol 12 (suppl 1): S3-S9.

  • 18. Weinberger M.H. Miller J.Z. Luft F.C. Grim C.E. Finenberg N.S. Definitions and characteristics of sodium sensitivity and blood pressure resistance Hypertension 1986; 8 (Suppl II):II-127-II134.

  • 19. Ferri C. Sodium-modulating hormones and the pressor response to sodium chloride in essential arterial hypertension. Ann Med Int. 1993; Apr - Jun; 8(2): 89-94.

  • 20. Overlack A. Divergent hemodynamic and hormonal responses to varying salt intake in normotensive subjects. Hypertension. 1993 Sep; 22(3): 331-8.

  • 21. Pimenta E Gaddam KK Oparil S Aban I Husain S. Dell’Italia JECalhoun DA.Salt Intake and Hypertension Effects of Dietary Sodium Reduction on Blood Pressure in Subjects With Resistant Hypertension. Hypertension. 2009; 54: 475-481

  • 22. Sullivan J.M. Ratts T.E. Sodium sensitivity in human subjects: hemodynamic and hormonal correlates. Hypertension 1988; 11: 717-23.

  • 23. Draaijer P. Salt-sensitivity testing in patients with borderline hypertension: reproducibility and potential mechanisms. J Hum Hypertens. 1995; Apr; 9(4): 263-9.

  • 24. Gerdts E. Salt sensitive essential hypertension evaluated by 24 hour ambulatory blood pressure.; Blood Press. 1994; Nov; 3(6): 375-80.

  • 25. Schwartz GL Bailey K Chapman AB et al. The role of plasma renin activity age and race in selecting effective initial drug therapy for hypertension. Am J Hypertens 2013; 26:957.

  • 26. Cappuccio FP Markandu ND Sagnella GA Mac- Gregor GA. Sodium restriction lowers high blood pressure through a decreased response of the renin system--direct evidence using saralasin. J Hypertens. 1985 Jun;3(3):243-7.

  • 27. Cody RJ Covit AB Schaer GL Laragh JH Sealey JE Feldschuh J. Sodium and water balance in chronic congestive heart failure. J Clin Invest 1986;77:1441-1452.

  • 28. Paterna S Gaspare P Fasullo S Sarullo FM Di Pasquale P. Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend? Clin Sci (Lond) 2008;114:221-230.

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