Salt sensitivity of blood pressure in patients with psoriasis on ciclosporin therapy.
BACKGROUND
Hypertension is one of the main side-effects of long-term therapy with ciclosporin. However, the influence of salt intake on the 24-h mean blood pressure of patients with psoriasis treated with ciclosporin is not known.


OBJECTIVE
To evaluate, in patients with psoriasis, the sodium sensitivity of the ciclosporin-induced rise in blood pressure.


METHODS
The 24-h ambulatory blood pressure was evaluated in 13 patients with psoriasis (age range 20-57 years) in two phases, before (phase I) and after the completion of 4 months of therapy with ciclosporin 3 mg kg(-1) daily (phase II). In both phases, the patients were studied in conditions of low sodium (LS) intake followed by a high sodium (HS) diet.


RESULTS
Twenty-four-hour mean +/- SD blood pressure during LS and HS intake was, respectively, 86.3 +/- 1.6 mmHg and 85.5 +/- 1.8 mmHg during phase I, and 88.5 +/- 1.5 mmHg and 91.8 +/- 2.2 mmHg (P < 0.001 vs. phase I, HS; P < 0.05 vs. phase II, LS) during phase II. The median (interquartile range) sodium sensitivity index was greater during phase II than during phase I: - 0.0028 (- 0.0071 to 0.0009) vs. 0.0065 (- 0.0055 to 0.0258) (P < 0.02). The plasma levels and the daily urinary excretion of noradrenaline did not differ between phases I and II.


CONCLUSIONS
The ciclosporin-induced rise in blood pressure is sodium sensitive. It is also suggested that sympathetic activation is not involved in the pathogenesis of ciclosporin-induced rise in blood pressure.
Magina
S
S
Department of Dermatology, Hospital S. João, Portugal.
Santos
J
J
Coroas
A
A
Oliveira
J G
JG
Serrão
P
P
Soares-Da-Silva
P
P
Resende
C
C
Pestana
M
M
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D016572:Cyclosporine / Q000009:adverse effects*; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000502:physiology; D009638:Norepinephrine / Q000097:blood / Q000652:urine; D011565:Psoriasis / Q000188:drug therapy* / Q000503:physiopathology; D012982:Sodium, Dietary / Q000008:administration & dosage*
D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D012982:Sodium, Dietary; D016572:Cyclosporine; D009638:Norepinephrine