Hypertension

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Introduction and Aims: Sodium sensitivity (SS) is a phenomenon in which significant changes in blood pressure (BP) are observed based on sodium intake. The renin—angiotensin—aldosterone system plays a critical role in sodium handling and hypertension. We identified the specific responses of renin and aldosterone based on dietary sodium intake and revealed the relationship between these hormonal changes and dietary sodium intake in patients with SS. Methods: In total, 61 subjects were available to analyze full data including PRA (plasma renin activity, (ng/mL/hr)) and aldosterone (ng/dL). Participants were all admitted to clinical research center and to given a low-sodium DASH diet (LSD, 100 mM NaCl/day) for 7 days and a high- sodium DASH diet (HSD, 300 mM NaCl/day) for the following 7 days. Fasting blood samples, 24 hr ambulatory blood pressure monitoring, and 24 hr urine collection were obtained on the last day of each diet period. Results: SS was found in 5 (14%) in normotensives, and 14 (51%) in hypertensives. The 24 hr BPs changed significantly in response to salt intake in all SS subjects, whether they had hypertension or not, but not in sodium resistant (SR) participants. In SR subjects, PRA and aldosterone decreased significantly after consuming the HSD irrespective of hypertension (normotensives, PRA, 2.868 2.311 vs. 1.358 ± 1.342, p < 0.0001; aldosterone, 18.914 ± 10.203 vs. 9.841 ± 6.105, p < 0.0001; hypertensives, PRA, 2.665 ± 1.635 vs. 1.184 ± 0.83, p = 0.0016; aldosterone, 21.762 ± 7.365 vs. 10.554 ± 4.398, p = 0.0003) (table 1). Moreover, a significant correlation was observed between PRA and aldosterone in SR subjects (table 2). In contrast, only hypertensive subjects showed a marked fall in PRA after consuming the HSD (1.299 ± 0.904 vs. 0.593 ± 0.479, p = 0.0193) among SS subjects. Conclusions: This study demonstrated the important roles and different responses of renin and aldosterone in SS and SR subjects based on dietary salt intake whether or not they had hypertension. Table 1. The response of PRA and aldosterone according to the amount of dietary sodium intake Table 2. Correlation analysis about PRA or aldosteone in response to the dietary intervention

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