Abnormal Renal Hemodynamics in Salt-Sensitive Patients with Essential Hypertension : THE 14th CONFERENCE ON THE PATHOGENESIS OF HYPERTENSION

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Thirty hypertensive patients were studied during a low-sodium diet for three days and high-sodium diet for six days. They were classified as "salt-sensitive" (SS) (n=10) or "non-salt-sensitive" (NSS) (n=20) based on the increase in mean blood pressure (BP) with changes in sodium intake from 25 mEq/day to 250 mEq/day (14.7 ± 1.3% versus 4.0 ± 0.8%, p < 0.001). With the high-sodium diet, the SS patients had a greater increase in cardiac output (p < 0.001) and the increment in mean BP with the salt loading significantly correlated to that in cardiac output (r=0.672, p < 0.01). Thus, the increase in BP during short-term salt loading may be attributed to the increase in cardiac output. The role of renal hemodynamics in the increment of BP with salt loading after sodium restriction was evaluated in six SS and 14 NSS patients. Although the glomerular filtration rate was not different in the two groups, the renal vascular resistance was greater (p < 0.05) in the SS patients than in the NSS ones. Moreover, renal vascular resistance positively correlated to the increment in mean BP with salt loading (r=0.612, p < 0.01). Thus, it is suggested that renal vasoconstriction may be an important factor influencing salt-sensitivity in essential hypertension, possibly via the impaired renal sodium excretion.
社団法人日本循環器学会の論文
1985-09-20