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. 1981 Jul 11;283(6284):94–97. doi: 10.1136/bmj.283.6284.94

Relation between arterial pressure, dietary sodium intake, and renin system in essential hypertension.

P S Parfrey, N D Markandu, J E Roulston, B E Jones, J C Jones, G A MacGregor
PMCID: PMC1506105  PMID: 6789950

Abstract

Forty-one patients with mild essential hypertension, 36 patients with severe hypertension, and 28 normotensive subjects were studied on a high sodium intake of 350 mmol/day for five days and low sodium intake of 10 mmol/day for five days. The fall in mean arterial pressure on changing from the high-sodium to the low-sodium diet was 0.7 +/- 1.7 mm Hg in normotensive subjects, 8 +/- 1.4 mm Hg in patients with mild hypertension, and 14.5 +/- 1.4 mm Hg in patients with severe hypertension. The fall in blood pressure was not correlated with age. Highly significant correlations were obtained for all subjects between the ratio of the fall in mean arterial pressure to the fall in urinary sodium excretion on changing from a high- to a low-sodium diet and (a) the level of supine blood pressure on normal diet, (b) the rise in plasma renin activity, and (c) the rise in plasma aldosterone. In patients with essential hypertension the blood pressure is sensitive to alterations in sodium intake. This may be partly due to some change either produced by or associated directly with the hypertension. A decreased responsiveness of the renin-angiotensin-aldosterone system shown in the patients with essential hypertension could partly account for the results.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BORST J. G., BORST-DE GEUS A. Hypertension explained by Starling's theory of circulatory homoeostasis. Lancet. 1963 Mar 30;1(7283):677–682. doi: 10.1016/s0140-6736(63)91443-0. [DOI] [PubMed] [Google Scholar]
  2. Burstyn P., Hornall D., Watchorn C. Sodium and potassium intake and blood pressure. Br Med J. 1980 Aug 23;281(6239):537–539. doi: 10.1136/bmj.281.6239.537. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Campese V. M., Myers M. R., DeQuattro V. Neurogenic factors in low renin essential hypertension. Am J Med. 1980 Jul;69(1):83–91. doi: 10.1016/0002-9343(80)90504-5. [DOI] [PubMed] [Google Scholar]
  4. Fujita T., Henry W. L., Bartter F. C., Lake C. R., Delea C. S. Factors influencing blood pressure in salt-sensitive patients with hypertension. Am J Med. 1980 Sep;69(3):334–344. doi: 10.1016/0002-9343(80)90002-9. [DOI] [PubMed] [Google Scholar]
  5. George C. F., Lewis P. J., Petrie A. Clinical experience with use of ultrasound sphygmomanometer. Br Heart J. 1975 Aug;37(8):804–807. doi: 10.1136/hrt.37.8.804. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Laragh J. H., Baer L., Brunner H. R., Buhler F. R., Sealey J. E., Vaughan E. D., Jr Renin, angiotensin and aldosterone system in pathogenesis and management of hypertensive vascular disease. Am J Med. 1972 May;52(5):633–652. doi: 10.1016/0002-9343(72)90054-x. [DOI] [PubMed] [Google Scholar]
  7. Luft F. C., Rankin L. I., Bloch R., Weyman A. E., Willis L. R., Murray R. H., Grim C. E., Weinberger M. H. Cardiovascular and humoral responses to extremes of sodium intake in normal black and white men. Circulation. 1979 Sep;60(3):697–706. doi: 10.1161/01.cir.60.3.697. [DOI] [PubMed] [Google Scholar]
  8. Morgan T., Adam W., Gillies A., Wilson M., Morgan G., Carney S. Hypertension treated by salt restriction. Lancet. 1978 Feb 4;1(8058):227–230. doi: 10.1016/s0140-6736(78)90479-8. [DOI] [PubMed] [Google Scholar]
  9. Parfrey P. S., Wright P., Ledingham J. M. Prolonged isometric exercise. Part 1: Effect on circulation and on renal excretion of sodium and potassium in mild essential hypertension. Hypertension. 1981 Mar-Apr;3(2):182–187. doi: 10.1161/01.hyp.3.2.182. [DOI] [PubMed] [Google Scholar]
  10. Parfrey P. S., Wright P., Ledingham J. M. Prolonged isometric exercise. Part 2: Effect on circulation and on renal excretion of sodium and potassium in young males genetically predisposed to hypertension. Hypertension. 1981 Mar-Apr;3(2):188–191. doi: 10.1161/01.hyp.3.2.188. [DOI] [PubMed] [Google Scholar]
  11. Parijs J., Joossens J. V., Van der Linden L., Verstreken G., Amery A. K. Moderate sodium restriction and diuretics in the treatment of hypertension. Am Heart J. 1973 Jan;85(1):22–34. doi: 10.1016/0002-8703(73)90522-x. [DOI] [PubMed] [Google Scholar]
  12. Romoff M. S., Keusch G., Campese V. M., Wang M. S., Friedler R. M., Weidmann P., Massry S. G. Effect of sodium intake on plasma catecholamines in normal subjects. J Clin Endocrinol Metab. 1979 Jan;48(1):26–31. doi: 10.1210/jcem-48-1-26. [DOI] [PubMed] [Google Scholar]
  13. Roulston J. E., MacGregor G. A. Measurement of plasma renin activity by radioimmunoassay after prolonged cold storage. Clin Chim Acta. 1978 Aug 15;88(1):45–48. doi: 10.1016/0009-8981(78)90147-x. [DOI] [PubMed] [Google Scholar]
  14. Schalekamp M. A., Schalekamp-Kuyken M. P., Birkenhäger W. H. Abnormal renal haemodynamics and renin suppression in hypertensive patients. Clin Sci. 1970 Jan;38(1):101–110. doi: 10.1042/cs0380101. [DOI] [PubMed] [Google Scholar]
  15. Schechter P. J., Horwitz D., Henkin R. I. Sodium chloride preference in essential hypertension. JAMA. 1973 Sep 10;225(11):1311–1315. [PubMed] [Google Scholar]
  16. Sullivan J. M., Ratts T. E., Taylor J. C., Kraus D. H., Barton B. R., Patrick D. R., Reed S. W. Hemodynamic effects of dietary sodium in man: a preliminary report. Hypertension. 1980 Jul-Aug;2(4):506–514. doi: 10.1161/01.hyp.2.4.506. [DOI] [PubMed] [Google Scholar]
  17. Swales J. D. Dietary salt and hypertension. Lancet. 1980 May 31;1(8179):1177–1179. doi: 10.1016/s0140-6736(80)91631-1. [DOI] [PubMed] [Google Scholar]
  18. de Wardener H. E., MacGregor G. A. Dahl's hypothesis that a saluretic substance may be responsible for a sustained rise in arterial pressure: its possible role in essential hypertension. Kidney Int. 1980 Jul;18(1):1–9. doi: 10.1038/ki.1980.104. [DOI] [PubMed] [Google Scholar]

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