Role of reactive hyperreninemia in blood pressure changes induced by sodium depletion in patients with refractory hypertension

Détails

ID Serval
serval:BIB_D1ADDBCE5708
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Role of reactive hyperreninemia in blood pressure changes induced by sodium depletion in patients with refractory hypertension
Périodique
Hypertension
Auteur(s)
Gavras H., Waeber B., Kershaw  G. R., Liang  C. S., Textor  S. C., Brunner  H. R., Tifft  C. P., Gavras I.
ISSN
0194-911X
Statut éditorial
Publié
Date de publication
1981
Peer-reviewed
Oui
Volume
3
Numéro
4
Pages
441-7
Langue
anglais
Notes
Journal Article
Research Support, U.S. Gov't, P.H.S.
Résumé
Sixteen patients with refractory hypertension were submitted to vigorous sodium depletion while cardiovascular homeostasis was monitored with measurements of hormonal and hemodynamic parameters and repeat saralasin tests. This regimen resulted in a negative sodium balance by an average of 300 mEq. The loss of sodium closely correlated to the decrease of body weight (r = 0.70, p less than 0.005). Blood pressure (BP) decreased from 176/166 +/- 8/3 to 155/109 +/-6/3 mm Hg. There was a significant correlation between percent increments in plasma renin activity (PRA) and the rise in plasma norepinephrine (r = 0.68, p less than 0.05) and a close negative correlation between percent increase in PRA and the ratio of fall in mean blood pressure (MAP) per unit of weight loss (r = -0.73, p less than 0.005). Thus, patients with the least percent increase in PRA demonstrated the greatest fall in BP per unit of weight loss, indicating that relative rather than absolute elevation of renin may be the factor limiting antihypertensive efficacy of sodium depletion. Sodium depletion induced increase in peripheral resistance and decrease in cardiac output, both mostly attributable to relative hyperreninemia. Indeed, the adverse hemodynamic changes were reversed by angiotensin inhibition, during which BP normalized. It is concluded that vigorous sodium depletion complemented by angiotensin blockade or suppression with sympatholytic agents improves management of otherwise refractory hypertension.
Mots-clé
Adult*Blood PressureBody Weight*Diet, Sodium-RestrictedFemaleHemodynamicsHumansHypertension/blood/*physiopathologyMaleMiddle AgedNorepinephrine/physiologyRenin/*bloodSaralasin/pharmacologySodium/physiologySympatholytics/pharmacology
Pubmed
Web of science
Création de la notice
04/03/2009 16:04
Dernière modification de la notice
03/03/2018 21:38
Données d'usage