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Moderate salt restriction effectively lowers blood pressure and degree of salt sensitivity is related to baseline concentration of renin and N-terminal atrial natriuretic peptide in plasma.

Melander, Olle LU ; Wowern, Fredrik LU ; Frandsen, Erik; Burri, Philippe LU ; Willsteen, Gunilla; Aurell, Mattias and Hulthén, Lennart LU (2007) In Journal of Hypertension 25(3). p.619-627
Abstract
Objective The effect of salt restriction on blood pressure is under intense debate. We tested the effect of 100 mmol salt reduction on ambulatory blood pressure (ABP) in 46 Swedish individuals, 39 of whom completed the study, using a double-blind, placebo-controlled, crossover design. Furthermore, we tested whether the basal plasma concentration of renin or N-terminal atrial natriuretic peptide (Nt-proANP) predict the degree of salt sensitivity. Methods Participants received all meals and drinks with a total daily NaCl content of 50 mmol during 8 weeks. In addition, NaCl capsules (1100 mmol/day) and corresponding placebo capsules were administered for 4 weeks each in random order. ABP after high-salt intake (1150 mmol/day) was compared... (More)
Objective The effect of salt restriction on blood pressure is under intense debate. We tested the effect of 100 mmol salt reduction on ambulatory blood pressure (ABP) in 46 Swedish individuals, 39 of whom completed the study, using a double-blind, placebo-controlled, crossover design. Furthermore, we tested whether the basal plasma concentration of renin or N-terminal atrial natriuretic peptide (Nt-proANP) predict the degree of salt sensitivity. Methods Participants received all meals and drinks with a total daily NaCl content of 50 mmol during 8 weeks. In addition, NaCl capsules (1100 mmol/day) and corresponding placebo capsules were administered for 4 weeks each in random order. ABP after high-salt intake (1150 mmol/day) was compared with ABP after low-salt intake (50 mmol/ day). Salt sensitivity was defined as the difference between 24-h systolic ABP at the high-salt versus the low-salt periods. Baseline renin and Nt-proANP were related to salt sensitivity. Results Lowering of salt intake from 150 to 50 mmol/day induced significant blood pressure reductions (mean reduction, 95% confidence interval) in systolic and diastolic 24-h ABP (5.8, 3.4-8.2 and 2.6, 0.91 -4.4 mmHg), daytime ABP (5.5, 2.9-8.1 and 2.3, 0.42-4.1 mmHg) and night-time ABP (6.4, 3.5-9.3 and 3.4, 1.4-5.5 mmHg). Baseline In(renin) correlated inversely with salt sensitivity (r = -0.50, P = 0.001) whereas baseline In(Nt-proANP) correlated directly (r = 0.33, P = 0.04). Conclusion Lowering of salt intake with 100 mmol/day induces clinically relevant ABP reductions. Renin and Nt-proANP, measured with individuals on their habitual diet, could be useful biomarkers to identify individuals with the greatest blood pressure-lowering benefit from reduced salt intake. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
salt, salt intake, renin, blood pressure, atrial natriuretic peptide, sensitivity
in
Journal of Hypertension
volume
25
issue
3
pages
619 - 627
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000244388800020
  • scopus:33846781416
ISSN
1473-5598
DOI
10.1097/HJH.0b013e328013cd50
language
English
LU publication?
yes
id
7e89e1f2-2103-4a24-a7cb-a825132427cb (old id 165880)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17278979&dopt=Abstract
date added to LUP
2007-07-26 13:12:45
date last changed
2017-05-21 04:24:55
@article{7e89e1f2-2103-4a24-a7cb-a825132427cb,
  abstract     = {Objective The effect of salt restriction on blood pressure is under intense debate. We tested the effect of 100 mmol salt reduction on ambulatory blood pressure (ABP) in 46 Swedish individuals, 39 of whom completed the study, using a double-blind, placebo-controlled, crossover design. Furthermore, we tested whether the basal plasma concentration of renin or N-terminal atrial natriuretic peptide (Nt-proANP) predict the degree of salt sensitivity. Methods Participants received all meals and drinks with a total daily NaCl content of 50 mmol during 8 weeks. In addition, NaCl capsules (1100 mmol/day) and corresponding placebo capsules were administered for 4 weeks each in random order. ABP after high-salt intake (1150 mmol/day) was compared with ABP after low-salt intake (50 mmol/ day). Salt sensitivity was defined as the difference between 24-h systolic ABP at the high-salt versus the low-salt periods. Baseline renin and Nt-proANP were related to salt sensitivity. Results Lowering of salt intake from 150 to 50 mmol/day induced significant blood pressure reductions (mean reduction, 95% confidence interval) in systolic and diastolic 24-h ABP (5.8, 3.4-8.2 and 2.6, 0.91 -4.4 mmHg), daytime ABP (5.5, 2.9-8.1 and 2.3, 0.42-4.1 mmHg) and night-time ABP (6.4, 3.5-9.3 and 3.4, 1.4-5.5 mmHg). Baseline In(renin) correlated inversely with salt sensitivity (r = -0.50, P = 0.001) whereas baseline In(Nt-proANP) correlated directly (r = 0.33, P = 0.04). Conclusion Lowering of salt intake with 100 mmol/day induces clinically relevant ABP reductions. Renin and Nt-proANP, measured with individuals on their habitual diet, could be useful biomarkers to identify individuals with the greatest blood pressure-lowering benefit from reduced salt intake.},
  author       = {Melander, Olle and Wowern, Fredrik and Frandsen, Erik and Burri, Philippe and Willsteen, Gunilla and Aurell, Mattias and Hulthén, Lennart},
  issn         = {1473-5598},
  keyword      = {salt,salt intake,renin,blood pressure,atrial natriuretic peptide,sensitivity},
  language     = {eng},
  number       = {3},
  pages        = {619--627},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Hypertension},
  title        = {Moderate salt restriction effectively lowers blood pressure and degree of salt sensitivity is related to baseline concentration of renin and N-terminal atrial natriuretic peptide in plasma.},
  url          = {http://dx.doi.org/10.1097/HJH.0b013e328013cd50},
  volume       = {25},
  year         = {2007},
}