Short- and long-term neuroadrenergic effects of moderate dietary sodium restriction in essential hypertension.
BACKGROUND
In essential hypertension, marked restrictions in dietary sodium intake cause in the short-term period an increase in muscle sympathetic nerve traffic (MSNA) and a baroreflex impairment. The present study was set out to assess on a long-term basis the neuroadrenergic and reflex effects of moderate sodium restriction.


RESULTS
In 11 untreated mild to moderate essential hypertensive patients (age 42.0+/-2.6 years, mean+/-SEM), we measured beat-to-beat blood pressure (Finapres), heart rate (ECG), and MSNA (microneurography) at rest and during stepwise intravenous infusions of phenylephrine and nitroprusside. Measurements were performed at regular sodium intake, after 1 and 8 weeks of low-sodium diet (80 mmol NaCl/d), and repeated again at regular sodium intake. After 1 week, urinary sodium excretion was markedly reduced. This was accompanied by a slight blood pressure reduction, no heart rate change, and a significant increase in plasma renin activity, aldosterone, and MSNA (+23.0+/-4.6% P<0.05). Whereas baroreflex heart-rate control was unchanged, baroreflex modulation of MSNA was reduced by 46.8+/-5.1% (P<0.01). At the end of the 8-week low-sodium diet, the neurohumoral and baroreflex responses were similar to the ones observed after 1 week of the dietary intervention. All changes disappeared when regular sodium diet was restored.


CONCLUSIONS
Thus, a moderate dietary sodium restriction triggers a sympathetic activation and a baroreflex impairment. Maintenance of low-sodium diet for several weeks does not attenuate these adverse adrenergic and reflex effects.
Grassi
Guido
G
Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Centro Interuniversitario di Fisiologia Clinica e Ipertensione and Istituto Auxologico Italiano, Milan, Italy.
Dell'Oro
Raffaella
R
Seravalle
Gino
G
Foglia
Gerardo
G
Trevano
Fosca Quarti
FQ
Mancia
Giuseppe
G
D000328:Adult; D017704:Baroreflex; D001794:Blood Pressure; D004039:Diet, Sodium-Restricted; D004573:Electrolytes / Q000097:blood / Q000652:urine; D004837:Epinephrine / Q000097:blood; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation; D009638:Norepinephrine / Q000097:blood; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013997:Time Factors
D004573:Electrolytes; D009638:Norepinephrine; D004837:Epinephrine