Immediate pressor response to oral salt and its assessment in the clinic: a time series clinical trial.
Arterial pressure
Blood pressure
Hypertension
Immediate pressor response
Pulse pressure
Sodium chloride
Systolic pressure
Journal
Clinical hypertension
ISSN: 2056-5909
Titre abrégé: Clin Hypertens
Pays: England
ID NLM: 101669508
Informations de publication
Date de publication:
15 Sep 2022
15 Sep 2022
Historique:
received:
04
08
2021
accepted:
06
05
2022
entrez:
14
9
2022
pubmed:
15
9
2022
medline:
15
9
2022
Statut:
epublish
Résumé
High blood pressure (BP) is associated with high-salt consumption especially in sub-Saharan Africa. Although the pressor effect of salt is viewed as a chronic effect, some studies suggest that a salty meal may increase BP immediately in some individuals, and that this effect may cause endothelial dysfunction. Therefore, the aim of our research was to study the immediate pressor response to oral salt (IPROS) and its determinants, with the expectation that a simple methodology may be devised to diagnose it in the clinic or in low-resource environments. We conducted a time series trial at Livingstone Central Hospital. We present data in 127 normotensive participants who ingested 2 g of sodium chloride; their BP was monitored for 120 minutes in intervals of 10 minutes. Sociodemographic and clinical data were collected. Descriptive and inferential statistics were used for analyses of data. Median age was 30 years (interquartile range, 22-46 years) and 52% were female patients. An increase of ≥10 mmHg in mean arterial pressure (MAP), considered a clinically significant IPROS, was present in 62% of participants. Systolic BP 30 minutes after the salt load was a significant predictor of IPROS, avoiding the need to calculate MAP in the clinic setting. We confirm the presence of an IPROS in a high proportion (62%) of otherwise normotensive participants. The average time course for this response was 30 minutes and its duration was sustained for the 120-minutes period of study in most of the participants. Prediction of IPROS by ∆SBP (change in systolic blood pressure) at 30 minutes allows for easy assessment of possible responder status in the clinic. Our data indicate that the IPROS to oral salt-loads in the range currently consumed by the Western world and African populations in single meals may increase the 24-hour BP load, which is a risk factor for hypertension and target organ damage. The relevance of our findings indicates the need to include dietary sodium assessment in the diagnosis, prevention, and management of high BP.
Sections du résumé
BACKGROUND
BACKGROUND
High blood pressure (BP) is associated with high-salt consumption especially in sub-Saharan Africa. Although the pressor effect of salt is viewed as a chronic effect, some studies suggest that a salty meal may increase BP immediately in some individuals, and that this effect may cause endothelial dysfunction. Therefore, the aim of our research was to study the immediate pressor response to oral salt (IPROS) and its determinants, with the expectation that a simple methodology may be devised to diagnose it in the clinic or in low-resource environments.
METHODS
METHODS
We conducted a time series trial at Livingstone Central Hospital. We present data in 127 normotensive participants who ingested 2 g of sodium chloride; their BP was monitored for 120 minutes in intervals of 10 minutes. Sociodemographic and clinical data were collected. Descriptive and inferential statistics were used for analyses of data.
RESULTS
RESULTS
Median age was 30 years (interquartile range, 22-46 years) and 52% were female patients. An increase of ≥10 mmHg in mean arterial pressure (MAP), considered a clinically significant IPROS, was present in 62% of participants. Systolic BP 30 minutes after the salt load was a significant predictor of IPROS, avoiding the need to calculate MAP in the clinic setting.
CONCLUSIONS
CONCLUSIONS
We confirm the presence of an IPROS in a high proportion (62%) of otherwise normotensive participants. The average time course for this response was 30 minutes and its duration was sustained for the 120-minutes period of study in most of the participants. Prediction of IPROS by ∆SBP (change in systolic blood pressure) at 30 minutes allows for easy assessment of possible responder status in the clinic. Our data indicate that the IPROS to oral salt-loads in the range currently consumed by the Western world and African populations in single meals may increase the 24-hour BP load, which is a risk factor for hypertension and target organ damage. The relevance of our findings indicates the need to include dietary sodium assessment in the diagnosis, prevention, and management of high BP.
Identifiants
pubmed: 36104796
doi: 10.1186/s40885-022-00209-2
pii: 10.1186/s40885-022-00209-2
pmc: PMC9476589
doi:
Types de publication
Journal Article
Langues
eng
Pagination
25Subventions
Organisme : FIC NIH HHS
ID : D43 TW009744
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009337
Pays : United States
Organisme : NIH HHS
ID : K01HL130497, R03HL155041, and R01HL144941
Pays : United States
Informations de copyright
© 2022. The Author(s).
Références
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Cell Metab. 2013 Jan 8;17(1):125-31
pubmed: 23312287
Electrolyte Blood Press. 2015 Jun;13(1):7-16
pubmed: 26240595
Hypertension. 1986 Jun;8(6 Pt 2):II127-34
pubmed: 3522418
Clin Hypertens. 2021 Jan 15;27(1):2
pubmed: 33446278
Pflugers Arch. 2015 Jun;467(6):1319-25
pubmed: 25027385
J Am Geriatr Soc. 2010 Nov;58(11):2232-4
pubmed: 21054307
Hypertension. 2001 Feb;37(2 Pt 2):429-32
pubmed: 11230313
Curr Opin Nephrol Hypertens. 2011 Jan;20(1):37-43
pubmed: 21088577
Am J Clin Nutr. 2011 Mar;93(3):500-5
pubmed: 21228265
PLoS One. 2014 Aug 04;9(8):e104300
pubmed: 25090232
Prog Cardiovasc Nurs. 2000 Fall;15(4):138-44
pubmed: 11098526
Pflugers Arch. 2013 Oct;465(10):1459-66
pubmed: 23686295
Postgrad Med J. 2020 Aug;96(1138):453-454
pubmed: 32404501
Br J Nutr. 2018 Oct;120(7):721-731
pubmed: 30105963
J Am Heart Assoc. 2017 Apr 1;6(4):
pubmed: 28365569
Hypertension. 1991 Jul;18(1):67-71
pubmed: 1860713
Kidney Blood Press Res. 2016;41(4):355-64
pubmed: 27327163
Medicine (Baltimore). 2015 Dec;94(50):e1959
pubmed: 26683910
Hypertension. 2016 Sep;68(3):e7-e46
pubmed: 27443572
J Nutr. 2020 Jan 1;150(1):55-63
pubmed: 31504721
Am J Physiol Renal Physiol. 2000 Apr;278(4):F585-95
pubmed: 10751219
J Clin Invest. 2017 May 1;127(5):1932-1943
pubmed: 28414302
J Clin Hypertens (Greenwich). 2020 Aug;22(8):1355-1370
pubmed: 32770701
Kidney Int. 2012 Feb;81(4):407-11
pubmed: 22048126
Crit Care. 2015 Mar 10;19:101
pubmed: 25888071
J Clin Hypertens (Greenwich). 2019 Jun;21(6):700-709
pubmed: 31087778
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660