Sodium sensitivity as a main determinant of blood pressure changes during early withdrawal in heavy alcoholics.
BACKGROUND
Stimulated sympathetic nervous system, renin-angiotensin-aldosterone system, vasopressin, and cortisol are thought to affect blood pressure in early withdrawal of alcoholics. Hyperactivity of sodium-retaining systems with consequent volume expansion also could interact with sodium sensitivity as previously found in long-term withdrawing alcoholics.


METHODS
To investigate this hypothesis, blood pressure and sodium balance were measured during the first 8 days of withdrawal in 18 chronic alcoholics on a 150 mM Na diet. Results were related to the Salt Sensitivity Index of blood pressure as measured in the same alcoholics after 1 year of abstinence.


RESULTS
Early withdrawal study: there was a positive sodium balance (+288.6 +/- 45.6 mM; p < 0.0001) and rise in mean arterial pressure (+11.8 +/- 2.9 mm Hg; p = 0.001) during early withdrawal on 150 mM Na diet. Salt Sensitivity Study after long-term detoxification: the shift from low (55 mM) to high sodium (260 mM) intake produced a larger (p = 0.04) increase in mean arterial pressure in alcoholics (+9.3 +/- 2.0 mm Hg) than in 30 teetotal controls (+5.1 +/- 1.1) (Salt Sensitivity Index, 0.047 +/- 0.008 vs. 0.023 +/- 0.0053; p < 0.05). Changes in mean blood pressure during withdrawal were highly related to sodium sensitivity index (r = 0.8; p < 0.001).


CONCLUSIONS
Early withdrawing alcoholics exposed to a normal sodium intake experience positive Na balance and increase in blood pressure that is related to sodium sensitivity measured after long-term detoxification. This suggests that salt sensitivity plays a key role in blood pressure regulation in early withdrawing alcoholics.
Di Gennaro
Cristiana
C
Center for Study and Treatment of Alcoholism at the Dipartimento di Medicina Interna e Scienze Biomediche, University of Parma, Italy. panorama@ipruniv.cce.uni
Vescovi
Pier Paolo
PP
Barilli
Angela Luciana
AL
Giuffredi
Cristina
C
Delsignore
Roberto
R
Montanari
Alberto
A
D000328:Adult; D000437:Alcoholism / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012982:Sodium, Dietary / Q000378:metabolism*; D013375:Substance Withdrawal Syndrome / Q000378:metabolism*
D012982:Sodium, Dietary