Abstract
Sixteen patients with refractory hypertension were submitted to vigorous sodium depletion while cardiovascular homeostasis was monitored with measurements of hormonal and hemodynamic parameters and repeat saralasin tests. This regimen resulted in a negative sodium balance by an average of 300 mEq. The loss of sodium closely correlated to the decrease of body weight (r = 0.70, p less than 0.005). Blood pressure (BP) decreased from 176/166 +/- 8/3 to 155/109 +/-6/3 mm Hg. There was a significant correlation between percent increments in plasma renin activity (PRA) and the rise in plasma norepinephrine (r = 0.68, p less than 0.05) and a close negative correlation between percent increase in PRA and the ratio of fall in mean blood pressure (MAP) per unit of weight loss (r = -0.73, p less than 0.005). Thus, patients with the least percent increase in PRA demonstrated the greatest fall in BP per unit of weight loss, indicating that relative rather than absolute elevation of renin may be the factor limiting antihypertensive efficacy of sodium depletion. Sodium depletion induced increase in peripheral resistance and decrease in cardiac output, both mostly attributable to relative hyperreninemia. Indeed, the adverse hemodynamic changes ...Continue Reading
References
Sep 30, 1978·Lancet·H R BrunnerH Gavras
Feb 1, 1978·The Journal of Clinical Endocrinology and Metabolism·H GavrasE J Rucinska
Jul 5, 1979·The New England Journal of Medicine·N K HollenbergG H Williams
Jan 1, 1979·British Journal of Clinical Pharmacology·H R BrunnerI Gavras
Dec 1, 1979·Clinical Science·A MimranD Brunner
Feb 1, 1975·Circulation Research·H GavrasI Gavras
May 1, 1978·Life Sciences·A A TaylorJ R Mitchell
Aug 1, 1978·The American Journal of Cardiology·F C WhiteC M Bloor
Jun 1, 1976·Life Sciences·C R LakeI J Kopin
Dec 2, 1976·The New England Journal of Medicine·H GavrasH R Brunner
Feb 1, 1975·Life Sciences·D P HenryR H Williams
Jun 27, 1975·Science·H GavrasJ H Laragh
Aug 10, 1974·Lancet·H GavrasJ H Laragh
Mar 2, 1972·The New England Journal of Medicine·H R BrunnerF R Bühler
Jan 1, 1972·The Journal of Clinical Investigation·H R BrunnerJ H Laragh
Jun 29, 1973·Science·H GavrasJ H Laragh
Apr 1, 1972·Kidney International·J E SealeyJ H Laragh
May 1, 1974·Kidney International·A MimranN K Hollenberg
Apr 20, 1972·The New England Journal of Medicine·H P DustanE L Bravo
Apr 1, 1970·Circulation·R C TaraziE D Frohlich
Aug 22, 1980·Science·P HatzinikolaouI Gavras
Citations
Oct 1, 1988·Journal of Steroid Biochemistry·B WaeberH R Brunner
Feb 14, 1983·Life Sciences·D DiPetteH Brunner
Apr 1, 1987·Molecular and Cellular Endocrinology·J GoldmanR Vukmirovich
Jul 22, 2009·Hypertension·Eduardo PimentaDavid A Calhoun
Oct 22, 1982·Pharmaceutisch Weekblad. Scientific Edition·W Soudijn
Aug 18, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rajiv Agarwal
Nov 1, 1993·Clinical and Experimental Hypertension : CHE·H R BrunnerB Waeber
Jan 1, 1982·Clinical and Experimental Hypertension. Part A, Theory and Practice·H Gavras
Jun 29, 1989·The New England Journal of Medicine
Jan 1, 1985·Behavior Modification·R G JacobW S Agras
May 1, 1982·Hypertension·H GavrasI Gavras
Feb 1, 1988·Hypertension·C I SaadH Gavras
May 1, 1981·Circulation Research·P A JohnstonN G Levinsky