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Sesa-Ashton G, Carnagarin R, Nolde JM, Muente I, Lee R, Macefield VG, Dawood T, Sata Y, Lambert EA, Lambert GW, Walton A, Kiuchi MG, Esler MD, Schlaich MP. Salt sensitivity risk derived from nocturnal dipping and 24-h heart rate predicts long-term blood pressure reduction following renal denervation. J Hypertens 2024; 42:922-927. [PMID: 38230602 DOI: 10.1097/hjh.0000000000003655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Renal denervation (RDN) has been consistently shown in recent sham-controlled clinical trials to reduce blood pressure (BP). Salt sensitivity is a critical factor in hypertension pathogenesis, but cumbersome to assess by gold-standard methodology. Twenty-four-hour average heart rate (HR) and mean arterial pressure (MAP) dipping, taken by ambulatory blood pressure monitoring (ABPM), stratifies patients into high, moderate, and low salt sensitivity index (SSI) risk categories. OBJECTIVES We aimed to assess whether ABPM-derived SSI risk could predict the systolic blood pressure reduction at long-term follow-up in a real-world RDN patient cohort. METHODS Sixty participants had repeat ABPM as part of a renal denervation long-term follow-up. Average time since RDN was 8.9 ± 1.2 years. Based on baseline ABPM, participants were stratified into low (HR < 70 bpm and MAP dipping > 10%), moderate (HR ≥70 bpm or MAP dipping ≤ 10%), and high (HR ≥ 70 bpm and MAP dipping ≤ 10%) SSI risk groups, respectively. RESULTS One-way ANOVA indicated a significant treatment effect ( P = 0.03) between low ( n = 15), moderate ( n = 35), and high ( n = 10) SSI risk with systolic BP reduction of 9.6 ± 3.7 mmHg, 8.4 ± 3.5 mmHg, and 28.2 ± 9.6 mmHg, respectively. Baseline BP was not significantly different between SSI Risk groups ( P = 0.18). High SSI risk independently correlated with systolic BP reduction ( P = 0.02). CONCLUSIONS Our investigation indicates that SSI risk may be a simple and accessible measure for predicting the BP response to RDN. However, the influence of pharmacological therapy on these participants is an important extraneous variable requiring testing in prospective or drug naive RDN cohorts.
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Affiliation(s)
- Gianni Sesa-Ashton
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute
| | - Revathy Carnagarin
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Janis M Nolde
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Ida Muente
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Rebecca Lee
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute
| | - Tye Dawood
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute
| | - Yusuke Sata
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Department of Cardiology, Alfred Health, Melbourne, Victoria
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne
| | - Antony Walton
- Department of Cardiology, Alfred Health, Melbourne, Victoria
| | - Marcio G Kiuchi
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Murray D Esler
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Department of Cardiology, Alfred Health, Melbourne, Victoria
| | - Markus P Schlaich
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
- Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia
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2
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Kim BS, Yu MY, Shin J. Effect of low sodium and high potassium diet on lowering blood pressure and cardiovascular events. Clin Hypertens 2024; 30:2. [PMID: 38163867 PMCID: PMC10759559 DOI: 10.1186/s40885-023-00259-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Incorporating aggressive lifestyle modifications along with antihypertensive medication therapy is a crucial treatment strategy to enhance the control rate of hypertension. Dietary modification is one of the important lifestyle interventions for hypertension, and it has been proven to have a clear effect. Among food ingredients, sodium and potassium have been found to have the strongest association with blood pressure. The blood pressure-lowering effect of a low sodium diet and a high potassium diet has been well established, especially in hypertensive population. A high intake of potassium, a key component of the Dietary Approaches to Stop Hypertension (DASH) diet, has also shown a favorable impact on the risk of cardiovascular events. Additionally, research conducted with robust measurement methods has shown cardiovascular benefits of low-sodium intake. In this review, we aim to discuss the evidence regarding the relationship between the low sodium and high potassium diet and blood pressure and cardiovascular events.
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Affiliation(s)
- Byung Sik Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea
| | - Mi-Yeon Yu
- Division of Nephrology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Hanyang University College of Medicine, 222, Wangsimni-ro, Sungdong-gu, Seoul, 04763, South Korea.
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3
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Drury ER, Wu J, Gigliotti JC, Le TH. Sex differences in blood pressure regulation and hypertension: renal, hemodynamic, and hormonal mechanisms. Physiol Rev 2024; 104:199-251. [PMID: 37477622 PMCID: PMC11281816 DOI: 10.1152/physrev.00041.2022] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/06/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023] Open
Abstract
The teleology of sex differences has been argued since at least as early as Aristotle's controversial Generation of Animals more than 300 years BC, which reflects the sex bias of the time to contemporary readers. Although the question "why are the sexes different" remains a topic of debate in the present day in metaphysics, the recent emphasis on sex comparison in research studies has led to the question "how are the sexes different" being addressed in health science through numerous observational studies in both health and disease susceptibility, including blood pressure regulation and hypertension. These efforts have resulted in better understanding of differences in males and females at the molecular level that partially explain their differences in vascular function and renal sodium handling and hence blood pressure and the consequential cardiovascular and kidney disease risks in hypertension. This review focuses on clinical studies comparing differences between men and women in blood pressure over the life span and response to dietary sodium and highlights experimental models investigating sexual dimorphism in the renin-angiotensin-aldosterone, vascular, sympathetic nervous, and immune systems, endothelin, the major renal sodium transporters/exchangers/channels, and the impact of sex hormones on these systems in blood pressure homeostasis. Understanding the mechanisms governing sex differences in blood pressure regulation could guide novel therapeutic approaches in a sex-specific manner to lower cardiovascular risks in hypertension and advance personalized medicine.
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Affiliation(s)
- Erika R Drury
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - Jing Wu
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, New York, United States
| | - Joseph C Gigliotti
- Department of Integrative Physiology and Pharmacology, Liberty University College of Osteopathic Medicine, Lynchburg, Virginia, United States
| | - Thu H Le
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, United States
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4
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Yang S, Wang H. Avoidance of added salt for 6-12-month-old infants: A narrative review. Arch Pediatr 2023; 30:595-599. [PMID: 37805298 DOI: 10.1016/j.arcped.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/12/2023] [Accepted: 08/07/2023] [Indexed: 10/09/2023]
Abstract
Most nutrition guidelines recommend avoiding foods with added salt for infants aged 6-12 months. However, the reason for no added salt lacks enough and reliable evidence. We re-searched and re-studied the relevant evidence. We searched PubMed and the Cochrane database for English-language studies published from 1904 through 2021. We also searched the databases of the websites of different national institutions. Randomized clinical trials (RCTs), systematic reviews, observational studies, and dietary guidelines were included in this review. The kidneys of infants aged 6-12 months have adequate sodium excretion capacity. There is insufficient evidence that high salt (sodium) intake early in life might lead to hypertension or salty diet preference in adults. Infants aged 6-12 months might be at risk of low sodium intake of only 150-300 mg of sodium/day, which may not meet the body's needs, if their supplementary food is not adequately salted.
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Affiliation(s)
- Shuling Yang
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hai Wang
- Pediatric Department, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
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5
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Daya NR, McEvoy JW, Christenson RH, Tang O, Foti K, Juraschek SP, Selvin E, Echouffo-Tcheugui JB. Prevalence of Elevated NT-proBNP and its Prognostic Value by Blood Pressure Treatment and Control. Am J Hypertens 2023; 36:602-611. [PMID: 37458697 PMCID: PMC10570660 DOI: 10.1093/ajh/hpad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/12/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The prognostic utility of NT-proBNP in the setting of hypertension has not been well-characterized in the general US adult population. METHODS We measured NT-proBNP in stored blood samples collected from participants 1 year or older who participated in the 1999-2004 National Health and Nutrition Examination Survey. In adults 20 years or older without a history of cardiovascular disease, we assessed the prevalence of elevated NT-pro-BNP by blood pressure (BP) treatment and control categories. We examined the extent to which NT-proBNP identifies participants at higher risk for mortality across BP treatment and control categories. RESULTS Among US adults without CVD, the prevalence of elevated NT-proBNP (≥125 pg/ml) was 27.2% among those with untreated hypertension, 24.9% among those with treated controlled hypertension, and 43.3% among those with treated uncontrolled hypertension. Over a median follow-up of 17.3 years and after adjusting for demographic and clinical risk factors, US adults with treated controlled hypertension and elevated NT-proBNP had increased risk of all-cause mortality (HR 2.29, 95% CI 1.79, 2.95) and cardiovascular mortality (HR 3.83, 95% CI 2.34, 6.29), compared to adults without hypertension and with low levels of NT-proBNP (<125 pg/ml). Across all levels of SBP and irrespective of antihypertensive medication use, elevated NT-proBNP was associated with an increased risk of mortality, compared to low levels of NT-proBNP. CONCLUSIONS Among a general population of adults free of CVD, NT-proBNP can provide additional prognostic information within and across categories of BP. Measurement of NT-proBNP may have potential for clinical use to optimize hypertension treatment.
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Affiliation(s)
- Natalie R Daya
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - John W McEvoy
- Division of Cardiology and National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Olive Tang
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kathryn Foti
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Stephen P Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth Selvin
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Justin B Echouffo-Tcheugui
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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6
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Romberger NT, Stock JM, Patik JC, McMillan RK, Lennon SL, Edwards DG, Farquhar WB. Inverse salt sensitivity in normotensive adults: role of demographic factors. J Hypertens 2023; 41:934-940. [PMID: 36928305 PMCID: PMC10228636 DOI: 10.1097/hjh.0000000000003413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Salt sensitivity and inverse salt sensitivity [ISS; a reduction in blood pressure (BP) on a high sodium diet] are each associated with increased incidence of hypertension. The purpose of this analysis was to determine the prevalence of ISS in normotensive adults and whether ISS is associated with any demographic characteristic(s). METHODS Healthy normotensive, nonobese adults [ n = 84; 43 women; age = 37 ± 13 years; baseline mean arterial pressure (MAP) = 89 ± 8 mmHg] participated in a controlled feeding study, consuming 7-day low-sodium (20 mmol sodium/day) and high-sodium (300 mmol sodium/day) diets. Twenty-four-hour ambulatory BP was assessed on the last day of each diet. ISS was defined as a reduction in 24-h MAP more than 5 mmHg, salt sensitivity as an increase in MAP more than 5 mmHg and salt resistance as a change in MAP between -5 and 5 mmHg from low sodium to high sodium. RESULTS Using this cutoff, 10.7% were ISS, 76.2% salt resistant, and 13.1% salt sensitive. Prevalence of ISS was similar between sexes and age groups ( P > 0.05). However, ISS was more prevalent in those with normal BMI (15.8% ISS) compared with those with overweight BMI (0% ISS; P < 0.01). Interestingly, classification of participants using a salt sensitivity index (ΔMAP/Δ urinary sodium excretion) categorized 21.4% as ISS, 48.8% salt resistant, and 29.8% salt sensitive. CONCLUSION Overall, we found that the prevalence of ISS was 10.7% (5 mmHg cutoff) or 21.4% (salt sensitivity index), and that ISS was associated with lower BMI. These results highlight the importance of future work to understand the mechanisms of ISS and to standardize salt sensitivity assessment.
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Affiliation(s)
- Nathan T Romberger
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
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7
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McNally RJ, Morselli F, Farukh B, Chowienczyk PJ, Faconti L. A pilot study to evaluate the erythrocyte glycocalyx sensitivity to sodium as a marker for cellular salt sensitivity in hypertension. J Hum Hypertens 2023; 37:286-291. [PMID: 35414109 PMCID: PMC10063440 DOI: 10.1038/s41371-022-00683-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 03/02/2022] [Accepted: 03/25/2022] [Indexed: 11/09/2022]
Abstract
Supressed plasma renin in patients with primary hypertension is thought to be an indirect marker of sodium-induced volume expansion which is associated with more severe hypertension and hypertension-mediated organ damage. A novel test for erythrocyte glycocalyx sensitivity to sodium (eGCSS) has been proposed as a direct measure of sodium-induced damage on erythrocyte surfaces and a marker of sensitivity of the endothelium to salt in humans. Here we explore if eGCSS relates to plasma renin and other clinical and biochemical characteristics in a cohort of patients with primary hypertension. Hypertensive subjects (n = 85, 54% male) were characterised by blood biochemistry (including plasma renin/aldosterone), urine analysis for albumin-creatinine ratio (ACR), 24-h urine sodium/potassium excretion. eGCSS was measured using a commercially available kit. Correlations between eGCSS and clinical and biochemical characteristics were explored using Spearman's correlation coefficient and characteristics compared across tertiles of eGCSS. eGCSS was inversely correlated with renin (p < 0.05), with renin 17.72 ± 18 µU/l in the highest tertile of eGCSS compared to 84.27 ± 146.5 µU/l in the lowest (p = 0.012). eGCSS was positively correlated with ACR (p < 0.01), with ACR 7.37 ± 15.29 vs. 1.25 ± 1.52 g/mol for the highest vs. lowest tertiles of eGCSS (p < 0.05). eGCSS was not correlated with other clinical characteristics or biochemical measures. These results suggests that sodium retention in hypertension characterised by a low-renin state is associated with cell membrane damage reflected by eGCSS. This may contribute to the hypertension-mediated organ damage and the excess mortality associated with sodium overload and "salt sensitivity".
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Affiliation(s)
- Ryan J McNally
- King's College London, Department of Clinical Pharmacology, British Heart Foundation Centre, London, UK
| | - Franca Morselli
- King's College London, Department of Clinical Pharmacology, British Heart Foundation Centre, London, UK
| | - Bushra Farukh
- King's College London, Department of Clinical Pharmacology, British Heart Foundation Centre, London, UK
| | - Phil J Chowienczyk
- King's College London, Department of Clinical Pharmacology, British Heart Foundation Centre, London, UK
| | - Luca Faconti
- King's College London, Department of Clinical Pharmacology, British Heart Foundation Centre, London, UK.
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8
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Daya NR, McEvoy JW, Christenson R, Tang O, Foti K, Juraschek SP, Selvin E, Tcheugui JBE. Prevalence of Elevated NT-proBNP and its Prognostic Value by Blood Pressure Treatment and Control- National Health and Nutrition Examination Survey, 1999-2004. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.20.23286211. [PMID: 36865209 PMCID: PMC9980258 DOI: 10.1101/2023.02.20.23286211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Background The prognostic utility of NT-proBNP in the setting of hypertension has not been well-characterized in the general US adult population. Methods We measured NT-proBNP among adults aged 20 years who participated in the 1999-2004 National Health and Nutrition Examination Survey. In adults without a history of cardiovascular disease, we assessed the prevalence of elevated NT-pro-BNP by blood pressure (BP) treatment and control categories. We examined the extent to which NT-proBNP identifies participants at higher risk for mortality across BP treatment and control categories. Results The number of US adults without CVD with elevated NT-proBNP (≥125 pg/ml) was 6.2 million among those with untreated hypertension, 4.6 million among those with treated controlled hypertension, and 5.4 million among those with treated uncontrolled hypertension. After adjusting for age, sex, body mass index, and race/ethnicity, participants with treated controlled hypertension and elevated NT-proBNP had increased risk of all-cause mortality (HR 2.29, 95% CI 1.79, 2.95) and increased risk of cardiovascular mortality (HR 3.83, 95% CI: 2.34, 6.29), compared to those without hypertension and with low levels of NT-proBNP (<125 pg/ml). Among those on antihypertensive medication, those with SBP 130-139 mm Hg and elevated NT-proBNP had increased risk of all-cause mortality, compared to those with SBP<120 mm Hg and low levels of NT-proBNP. Conclusions Among a general population of adults free of cardiovascular disease, NT-proBNP can provide additional prognostic information within and across categories of BP. Measurement of NT-proBNP may have potential for clinical use to optimize hypertension treatment.
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Affiliation(s)
- Natalie R Daya
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John W McEvoy
- Division of Cardiology and National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - Robert Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Olive Tang
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathryn Foti
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Stephen P Juraschek
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Elizabeth Selvin
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Justin B Echouffo Tcheugui
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism; Johns Hopkins University School of Medicine, Baltimore, MD, USA
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9
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Kang EJ, Prager O, Lublinsky S, Oliveira-Ferreira AI, Reiffurth C, Major S, Müller DN, Friedman A, Dreier JP. Stroke-prone salt-sensitive spontaneously hypertensive rats show higher susceptibility to spreading depolarization (SD) and altered hemodynamic responses to SD. J Cereb Blood Flow Metab 2023; 43:210-230. [PMID: 36329390 PMCID: PMC9903222 DOI: 10.1177/0271678x221135085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Spreading depolarization (SD) occurs in a plethora of clinical conditions including migraine aura, delayed ischemia after subarachnoid hemorrhage and malignant hemispheric stroke. It describes waves of near-breakdown of ion homeostasis, particularly Na+ homeostasis in brain gray matter. SD induces tone alterations in resistance vessels, causing either hyperperfusion in healthy tissue; or hypoperfusion (inverse hemodynamic response = spreading ischemia) in tissue at risk. Observations from mice with genetic dysfunction of the ATP1A2-encoded α2-isoform of Na+/K+-ATPase (α2NaKA) suggest a mechanistic link between (1) SD, (2) vascular dysfunction, and (3) salt-sensitive hypertension via α2NaKA. Thus, α2NaKA-dysfunctional mice are more susceptible to SD and show a shift toward more inverse hemodynamic responses. α2NaKA-dysfunctional patients suffer from familial hemiplegic migraine type 2, a Mendelian model disease of SD. α2NaKA-dysfunctional mice are also a genetic model of salt-sensitive hypertension. To determine whether SD thresholds and hemodynamic responses are also altered in other genetic models of salt-sensitive hypertension, we examined these variables in stroke-prone spontaneously hypertensive rats (SHRsp). Compared with Wistar Kyoto control rats, we found in SHRsp that electrical SD threshold was significantly reduced, propagation speed was increased, and inverse hemodynamic responses were prolonged. These results may have relevance to both migraine with aura and stroke.
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Affiliation(s)
- Eun-Jeung Kang
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ofer Prager
- Department of Physiology & Cell Biology, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Svetlana Lublinsky
- Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ana I Oliveira-Ferreira
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Clemens Reiffurth
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sebastian Major
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité - Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Alon Friedman
- Department of Physiology & Cell Biology, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Medical Neuroscience and Brain Repair Center, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jens P Dreier
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany.,Einstein Center for Neurosciences Berlin, Berlin, Germany
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10
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Zhang F, Xie Y, Yang X, Peng W, Qi H, Li B, Wen F, Li P, Sun Y, Zhang L. Association of Serum Metabolites and Salt Sensitivity of Blood Pressure in Chinese Population: The EpiSS Study. Nutrients 2023; 15:nu15030690. [PMID: 36771399 PMCID: PMC9921558 DOI: 10.3390/nu15030690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND To identify novel metabolites associated with salt sensitivity of blood pressure (SSBP) in Chinese Han population. METHODS A case-control study was conducted with 25 salt sensitive (SS) and 26 salt resistant (SR) participants, which was selected from the Systems Epidemiology Study on Salt Sensitivity of Blood Pressure (EpiSS) study. The modified Sullivan's acute oral saline load and diuresis shrinkage test (MSAOSL-DST) was conducted to identify SS. Untargeted, ultra-high performance liquid chromatograph-high resolution mass spectrometer (UPLC-HRMS) was conducted and orthogonal partial least squares-discriminate analysis (OPLS-DA) and multivariable logistic regression model were used to screen the metabolites related to SS, mixed linear regressions models were used to examined the association of SSBP with metabolites during saline load period and diuresis shrinkage period. Receiver operating characteristic (ROC) curve analysis was performed. The area under the curve's (AUC) sensitivity and specificity were calculated to identified metabolites biomarkers for SS. RESULTS There were 39 differentially expressed metabolites (DE-metabolites) between SS and SR. Thirty-five and four of DE-metabolites were inversely or positively associated with SS, respectively. Four biochemical pathways demonstrated significant enrichment for identified metabolites. In single-metabolite analyses, L-Glutamine displayed the best diagnostic performance (AUC = 0.88, 95% CI: 0.78-0.97). In multi-metabolites analyses, L-Glutamine + Cholesterol ester 22:5n6 combination showed the best diagnostic performance (AUC = 0.96, 95% CI: 0.91-1.00). Adjusted for traditional risk factors, L-Glutamine and Cholesterol ester 22:5n6 explained an additional 38.3% of SS susceptibility. CONCLUSIONS This study provide potential evidence for clarifying the mechanism of SS and provide novel biological insights into salt sensitive hypertension.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ling Zhang
- Correspondence: ; Tel./Fax: +86-010-83911777
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11
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Ou H, Liu D, Zhao G, Gong C, Li Y, Zhao Q. Association between AT1 receptor gene polymorphism and left ventricular hypertrophy and arterial stiffness in essential hypertension patients: a prospective cohort study. BMC Cardiovasc Disord 2022; 22:571. [PMID: 36577936 PMCID: PMC9795750 DOI: 10.1186/s12872-022-03024-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AT1 receptor gene (AGTR1) is related to essential hypertension (EH), and left ventricular hypertrophy (LVH) and arterial stiffness are common complications of EH. This study aimed to explore the association between AGTR1 genotype and LVH and arterial stiffness in EH patients. METHODS A total of 179 EH patients were recruited in this study. Oral exfoliated cells were collected from each patient, and the genetic polymorphism of AGTR1(rs4524238) was assessed using a gene sequencing platform. The outcomes were LVH and arterial stiffness. RESULTS Among 179 patients, 114 were with AGTR1 genotype of GG (57 males, aged 59.54 ± 13.49 years) and 65 were with AGTR1 genotype of GA or AA (36 males, aged 61.28 ± 12.79 years). Patients with AGTR1 genotype of GG were more likely to have LVH (47 [41.23%] vs. 14 [21.54%], P = 0.006) and arterial stiffness (30 [26.32%] vs. 8 [12.31%], P = 0.036). The AGTR1 polymorphism frequency was in accordance with Hardy-Weinberg equilibrium (P = 0.291). The multivariate logistic regression showed that AGTR1 genotype of GA or AA was independently associated with lower risk of LVH (OR = 0.344, 95%CI 160~0.696, P = 0.003) and arterial stiffness (OR = 0.371, 95%CI 0.155~0.885, P = 0.025) after adjusting for gender, age, and diabetes. CONCLUSION EH patients with the AGTR1 genotype of GA or AA were at lower risk for LVH and arterial stiffness than those with the GG genotype.
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Affiliation(s)
- Hangjun Ou
- grid.452244.1Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 Guizhou China
| | - Danan Liu
- grid.452244.1Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 Guizhou China
| | - Guangjian Zhao
- grid.452244.1Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 Guizhou China
| | - Caiwei Gong
- grid.452244.1Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 Guizhou China
| | - Yunyun Li
- grid.452244.1Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 Guizhou China
| | - Quanwei Zhao
- grid.452244.1Department of Cardiology, Affiliated Hospital of Guizhou Medical University, Guiyang, 550004 Guizhou China
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Gildea JJ, Xu P, Schiermeyer KA, Yue W, Carey RM, Jose PA, Felder RA. Inverse Salt Sensitivity of Blood Pressure Is Associated with an Increased Renin-Angiotensin System Activity. Biomedicines 2022; 10:2811. [PMID: 36359330 PMCID: PMC9687845 DOI: 10.3390/biomedicines10112811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
High and low sodium diets are associated with increased blood pressure and cardiovascular morbidity and mortality. The paradoxical response of elevated BP in low salt diets, aka inverse salt sensitivity (ISS), is an understudied vulnerable 11% of the adult population with yet undiscovered etiology. A linear relationship between the number of single nucleotide polymorphisms (SNPs) in the dopamine D2 receptor (DRD2, rs6276 and 6277), and the sodium myo-inositol cotransporter 2 (SLC5A11, rs11074656), as well as decreased expression of these two genes in urine-derived renal proximal tubule cells (uRPTCs) isolated from clinical study participants suggest involvement of these cells in ISS. Insight into this newly discovered paradoxical response to sodium is found by incubating cells in low sodium (LS) conditions that unveil cell physiologic differences that are then reversed by mir-485-5p miRNA blocker transfection and bypassing the genetic defect by DRD2 re-expression. The renin-angiotensin system (RAS) is an important counter-regulatory mechanism to prevent hyponatremia under LS conditions. Oversensitive RAS under LS conditions could partially explain the increased mortality in ISS. Angiotensin-II (AngII, 10 nmol/L) increased sodium transport in uRPTCs to a greater extent in individuals with ISS than SR. Downstream signaling of AngII is verified by identifying lowered expression of nuclear factor erythroid 2-related factor 2 (NRF2), CCCTC-binding factor (CTCF), and manganese-dependent mitochondrial superoxide dismutase (SOD2) only in ISS-derived uRPTCs and not SR-derived uRPTCs when incubated in LS conditions. We conclude that DRD2 and SLC5A11 variants in ISS may cause an increased low sodium sensitivity to AngII and renal sodium reabsorption which can contribute to inverse salt-sensitive hypertension.
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Affiliation(s)
- John J. Gildea
- Department of Pathology, The University of Virginia, Charlottesville, VA 22903, USA; (J.J.G.); (P.X.); (K.A.S.); (W.Y.)
| | - Peng Xu
- Department of Pathology, The University of Virginia, Charlottesville, VA 22903, USA; (J.J.G.); (P.X.); (K.A.S.); (W.Y.)
| | - Katie A. Schiermeyer
- Department of Pathology, The University of Virginia, Charlottesville, VA 22903, USA; (J.J.G.); (P.X.); (K.A.S.); (W.Y.)
| | - Wei Yue
- Department of Pathology, The University of Virginia, Charlottesville, VA 22903, USA; (J.J.G.); (P.X.); (K.A.S.); (W.Y.)
| | - Robert M. Carey
- Division of Endocrinology and Metabolism, Department of Medicine, The University of Virginia, Charlottesville, VA 22903, USA;
| | - Pedro A. Jose
- Division of Renal Diseases & Hypertension, Department of Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20052, USA;
- Department of Physiology/Pharmacology, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20052, USA
| | - Robin A. Felder
- Department of Pathology, The University of Virginia, Charlottesville, VA 22903, USA; (J.J.G.); (P.X.); (K.A.S.); (W.Y.)
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Zeng M, Xie Z, Zhang J, Li S, Wu Y, Yan X. Arctigenin Attenuates Vascular Inflammation Induced by High Salt through TMEM16A/ESM1/VCAM-1 Pathway. Biomedicines 2022; 10:2760. [PMID: 36359280 PMCID: PMC9687712 DOI: 10.3390/biomedicines10112760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 02/25/2024] Open
Abstract
Salt-sensitive hypertension is closely related to inflammation, but the mechanism is barely known. Transmembrane member 16A (TMEM16A) is the Ca2+-activated chloride channel in epithelial cells, smooth muscle cells, and sensory neurons. It can promote inflammatory responses by increasing proinflammatory cytokine release. Here, we identified a positive role of TMEM16A in vascular inflammation. The expression of TMEM16A was increased in high-salt-stimulated vascular smooth muscle cells (VSMCs), whereas inhibiting TMEM16A or silencing TMEM16A with small interfering RNA (siRNA) can abolish this effect in vitro or in vivo. Transcriptome analysis of VSMCs revealed some differential downstream genes of TMEM16A related to inflammation, such as endothelial cell-specific molecule 1 (ESM1) and CXC chemokine ligand 16 (CXCL16). Overexpression of TMEM16A in VSMCs was accompanied by high levels of ESM1, CXCL16, intercellular adhesion molecule-1 (ICAM-1), and vascular adhesion molecule-1 (VCAM-1). We treated VSMCs cultured with high salt and arctigenin (ARC), T16Ainh-A01 (T16), and TMEM16A siRNA (siTMEM16A), leading to greatly decreased ESM1, CXCL16, VCAM-1, and ICAM-1. Beyond that, silencing ESM1, the expression of VCAM-1 and ICAM-1, and CXCL16 was attenuated. In conclusion, our results outlined a signaling scheme that increased TMEM16 protein upregulated ESM1, which possibly activated the CXCL16 pathway and increased VCAM-1 and ICAM-1 expression, which drives VSMC inflammation. Beyond that, arctigenin, as a natural inhibitor of TMEM16A, can reduce the systolic blood pressure (SBP) of salt-sensitive hypertension mice and alleviate vascular inflammation.
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Affiliation(s)
- Mengying Zeng
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ziyan Xie
- Key Laboratory of Endocrinology, Department of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jiahao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Shicheng Li
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yanxiang Wu
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xiaowei Yan
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Inverse salt sensitivity: an independent risk factor for cardiovascular damage in essential hypertension. J Hypertens 2022; 40:1504-1512. [PMID: 35881450 DOI: 10.1097/hjh.0000000000003174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Salt sensitivity is a powerful risk factor for cardiovascular (CV) disease and mortality in both normotensive and hypertensive patients. We investigated the predictive value of the salt sensitivity phenotype in the development of CV events and hypertensive target organ damage (TOD) among essential hypertensive patients. METHODS Eight hundred forty-four naive hypertensive patients were recruited and underwent an acute saline test during which blood pressure (BP) displayed either no substantial variation (salt-resistant, SR individuals), an increase (salt-sensitive, SS), or a paradoxical decrease (inverse salt-sensitive, ISS). Sixty-one patients with the longest monitored follow-up (median 16 years) for blood pressure and organ damage were selected for the present study. A clinical score for TOD development based on the severity and the age of onset was set up by considering hypertensive heart disease, cerebrovascular damage, microalbuminuria, and vascular events. RESULTS CV events were significantly higher among SS and ISS than in SR patients. The relative risk of developing CV events was 12.67 times higher in SS than SR and 5.94 times higher in ISS than SR patients. The development of moderate to severe TOD was 10-fold higher in SS and over 15-fold higher in ISS than in SR patients. Among the three phenotypes, changes in plasma endogenous ouabain were linked with the blood pressure effects of saline. CONCLUSIONS Salt sensitivity and inverse salt sensitivity appear to be equivalent risk factors for CV events. The response to an acute saline test is predictive of CV damage for newly identified ISS individuals.
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15
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Inverse Salt Sensitivity of Blood Pressure: Mechanisms and Potential Relevance for Prevention of Cardiovascular Disease. Curr Hypertens Rep 2022; 24:361-374. [PMID: 35708819 DOI: 10.1007/s11906-022-01201-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW To review the etiology of inverse salt sensitivity of blood pressure (BP). RECENT FINDINGS Both high and low sodium (Na+) intake can be associated with increased BP and cardiovascular morbidity and mortality. However, little is known regarding the mechanisms involved in the increase in BP in response to low Na+ intake, a condition termed inverse salt sensitivity of BP, which affects approximately 15% of the adult population. The renal proximal tubule is important in regulating up to 70% of renal Na+ transport. The renin-angiotensin and renal dopaminergic systems play both synergistic and opposing roles in the regulation of Na+ transport in this nephron segment. Clinical studies have demonstrated that individuals express a "personal salt index" (PSI) that marks whether they are salt-resistant, salt-sensitive, or inverse salt-sensitive. Inverse salt sensitivity results in part from genetic polymorphisms in various Na+ regulatory genes leading to a decrease in natriuretic activity and an increase in renal tubular Na+ reabsorption leading to an increase in BP. This article reviews the potential mechanisms of a new pathophysiologic entity, inverse salt sensitivity of BP, which affects approximately 15% of the general adult population.
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Epithelial Sodium Channel Alpha Subunit (αENaC) Is Associated with Inverse Salt Sensitivity of Blood Pressure. Biomedicines 2022; 10:biomedicines10050981. [PMID: 35625718 PMCID: PMC9138231 DOI: 10.3390/biomedicines10050981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 01/07/2023] Open
Abstract
Salt sensitivity of blood pressure (BP) refers to an increase in BP following an increase in dietary salt, which is associated with increased incidence of cardiovascular disease and early death. However, decreased sodium intake also increases mortality and morbidity. Inverse salt sensitivity (ISS), defined as a paradoxical increase in BP on a low-salt diet, about 11% of the population, may be the cause of this phenomenon. The epithelial sodium channel (ENaC) is a major regulator of sodium reabsorption in the kidney. In this study, human renal tubular epithelial cells (hRTC) were cultured from the urine of phenotyped salt study participants. αENaC expression was significantly lower in ISS than salt resistant (SR) hRTC, while ENaC-like channel activity was dramatically increased by trypsin treatment in ISS cells analyzed by patch clamp. αENaC expression was also decreased under high-salt treatment and increased by aldosterone treatment in ISS cells. Moreover, the αENaC variant, rs4764586, was more prevalent in ISS. In summary, αENaC may be associated with ISS hypertension on low salt. These findings may contribute to understanding the mechanisms of ISS and low salt effect on morbidity and mortality.
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Association of Circulating Biomarkers of lnc-IGSF3-1:1, SCOC-AS1, and SLC8A1-AS1 with Salt Sensitivity of Blood Pressure in Chinese Population. J Cardiovasc Transl Res 2021; 15:906-917. [PMID: 34855149 DOI: 10.1007/s12265-021-10190-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/16/2021] [Indexed: 01/24/2023]
Abstract
Accumulating evidence suggested that long non-coding RNAs (lncRNAs) could play biological roles in cardiovascular diseases. We investigated whether lncRNAs can serve as biomarkers for salt sensitivity of blood pressure (SSBP). Participants were divided into salt-sensitive (SS) and salt-resistant (SR) ones by oral saline test. LncRNAs were tested by microarray (N = 20) and two-stage qRT-PCR (N = 89 and 228). We identified five differently expressed lncRNAs (lnc-IGSF3-1:1, SCOC-AS1, SLC8A1-AS1, KCNQ1OT1, and lnc-GNG-10-3:1) between SS and SR. In single-lncRNA analyses, lnc-IGSF3-1:1 displayed better diagnostic performance in hypertensive patients (AUC = 0.840), while SCOC-AS1 in normotensive (AUC = 0.810). In multi-lncRNA analyses, lnc-IGSF3-1:1 + SCOC-AS1 + SLC8A1-AS1 combination showed the best diagnostic performance in hypertensive (AUC = 0.853) and normotensive groups (AUC = 0.873). We constructed a lncRNA-mRNA-GO-KEGG-disease network by bioinformatic analysis; lnc-IGSF3-1:1 and SLC8A1-AS1 were identified as hub biomarkers. Our findings suggest that lnc-IGSF3-1:1, SCOC-AS1, and SLC8A1-AS1 may represent as genetic susceptible biomarkers for SSBP, and had different SS diagnostic performance in hypertensive patients and normotensive individuals.
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Yang J, Zou X, Jose PA, Zeng C. Extracellular vesicles: Potential impact on cardiovascular diseases. Adv Clin Chem 2021; 105:49-100. [PMID: 34809830 DOI: 10.1016/bs.acc.2021.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Extracellular vesicles (EVs) have received considerable attention in biological and clinical research due to their ability to mediate cell-to-cell communication. Based on their size and secretory origin, EVs are categorized as exosomes, microvesicles, and apoptotic bodies. Increasing number of studies highlight the contribution of EVs in the regulation of a wide range of normal cellular physiological processes, including waste scavenging, cellular stress reduction, intercellular communication, immune regulation, and cellular homeostasis modulation. Altered circulating EV level, expression pattern, or content in plasma of patients with cardiovascular disease (CVD) may serve as diagnostic and prognostic biomarkers in diverse cardiovascular pathologies. Due to their inherent characteristics and physiological functions, EVs, in turn, have become potential candidates as therapeutic agents. In this review, we discuss the evolving understanding of the role of EVs in CVD, summarize the current knowledge of EV-mediated regulatory mechanisms, and highlight potential strategies for the diagnosis and therapy of CVD. We also attempt to look into the future that may advance our understanding of the role of EVs in the pathogenesis of CVD and provide novel insights into the field of translational medicine.
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Affiliation(s)
- Jian Yang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Xue Zou
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, PR China; Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, PR China
| | - Pedro A Jose
- Division of Renal Disease & Hypertension, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Chunyu Zeng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, PR China; Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, PR China; State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, The Third Military Medical University, Chongqing, PR China; Heart Center of Fujian Province, Union Hospital, Fujian Medical University, Fuzhou, PR China.
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Minamino H, Katsushima M, Fujita Y, Hashimoto M. Comment on "Urinary sodium-to-potassium ratio associates with hypertension and current disease activity in patients with rheumatoid arthritis: a cross-sectional study": authors' reply. Arthritis Res Ther 2021; 23:195. [PMID: 34289886 PMCID: PMC8293581 DOI: 10.1186/s13075-021-02577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/07/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hiroto Minamino
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan. .,Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.
| | - Masao Katsushima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan
| | - Yoshihito Fujita
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan
| | - Motomu Hashimoto
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan. .,Department of Clinical Immunology, Graduate School of Medicine, Osaka City University, 1-4-3-13F Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
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Valtuille R. Potential Novel Benefits of Sodium Restriction in Chronic Kidney Disease. Curr Hypertens Rev 2021; 17:59-66. [PMID: 32538730 DOI: 10.2174/1573402116666200615152139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/20/2020] [Accepted: 04/30/2020] [Indexed: 11/22/2022]
Abstract
Chronic kidney disease is a global public health issue, and it has been considered as the epidemic of the 21st century. Therefore, all initiatives addressed to slow down the evolution and complications of this condition should be well received. While the effects of salt reduction on cardiovascular disease have some controversial issues, in chronic kidney disease, such a policy is beneficial in multiple aspects. In chronic kidney disease patients, dietary sodium restriction is regularly recommended to control extracellular fluid expansion, hypertension and cardiovascular risk. Instead, the effects of sodium reduction on chronic kidney disease progression are still controversial. In the last years, potentially beneficial effects of a low sodium diet on chronic kidney disease evolution have emerged. Firstly, recent magnetic resonance-based findings of increased Na depots in skin and muscle associated with renal function, ageing and sodium intake open a vast body of investigation as a potential tool for monitoring effects of sodium restriction. In this narrative review, we also discussed novel aspects of sodium restriction in chronic kidney disease to manage metabolic acidosis as well as renal effects on fibroblast growth factor 23 or gut microbiota. Beyond current evidence, these approaches showed that common findings of kidney failure environment such as sodium -sensitivity, micro-inflammation, arterial stiffness metabolic acidosis and sarcopenia could be delayed controlling dietary sodium. Additional studies are now needed in populations with chronic kidney disease to confirm these new findings, addressed to slow down the evolution and complications of this condition.
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Affiliation(s)
- Rodolfo Valtuille
- Department of Clinical Research, Universidad Nacional Guillermo Brown, 2289 Espora Avenue, Burzaco, B1852FZD Buenos Aires, Argentina
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Yue W, Tran HT, Wang JP, Schiermeyer K, Gildea JJ, Xu P, Felder RA. The Hypertension Related Gene G-Protein Coupled Receptor Kinase 4 Contributes to Breast Cancer Proliferation. Breast Cancer (Auckl) 2021; 15:11782234211015753. [PMID: 34103922 PMCID: PMC8145586 DOI: 10.1177/11782234211015753] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/12/2021] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Clinical studies have shown that breast cancer risk is increased in hypertensive women. The underlying molecular mechanism remains undetermined. The current study tests our hypothesis that G protein coupled receptor kinase 4 (GRK4) is a molecule that links hypertension and breast cancer. GRK4 plays an important role in regulation of renal sodium excretion. Sustained activation of GRK4 as in the circumstances of single nucleotide polymorphism (SNPs) causes hypertension. Expression of GRK4 in the kidney is regulated by cMyc, an oncogene that is amplified in breast cancer. METHODS Western analysis was used to evaluate GRK4 protein expression in seven breast cancer cell lines. GRK4 gene single nucleotide polymorphism in breast cancer cell lines and in breast cancer cDNA arrays were determined using TaqMan Genotyping qPRC. The function of GRK4 was evaluated in MCF-7 cells with cMyc knock-down and GRK4 re-expression and in MDA-MB-468 cells expressing inducible GRK4 shRNA lentivirus constructs. Nuclei counting and 5-Bromo-2'-deoxy-uridine (BrdU) labeling were used to evaluate cell growth and proliferation. RESULTS Genotyping of GRK4 SNPs in breast cancer cDNA arrays (n = 94) revealed that the frequency of carrying two hypertension related SNPs A142 V or R65 L is threefold higher in breast cancer patients than in healthy people (P = 7.53E-11). GRK4 protein is expressed in seven breast cancer cell lines but not the benign mammary epithelial cell line, MCF-10A. Three hypertension related SNPs in the GRK4 gene were identified in the breast cancer cell lines. Except for BT20, all other breast cancer lines have 1-3 GRK4 SNPs of which A142 V occurs in all 6 lines. MDA-MB-468 cells contain homozygous A142 V and R65 L SNPs. Knocking down cMyc in MCF-7 cells significantly reduced the growth rate, which was rescued by re-expression of GRK4. We then generated three stable GRK4 knock-down MDA-MB-468 lines using inducible lentiviral shRNA vectors. Doxycycline (Dox) induced GRK4 silencing significantly reduced GRK4 mRNA and protein levels, growth rates, and proliferation. As a marker of cell proliferation, the percentage of BrdU-labeled cells decreased from 45 ± 3% in the cells without Dox to 32 ± 5% in the cells treated with 0.1 µg/mL Dox. CONCLUSIONS GRK4 acts as an independent proliferation promotor in breast cancer. Our results suggest that targeted inhibition of GRK4 could be a new therapy for both hypertension and breast cancer.
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Affiliation(s)
- Wei Yue
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Hanh T. Tran
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Ji-ping Wang
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Katherine Schiermeyer
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - John J. Gildea
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Peng Xu
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Robin A. Felder
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
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Wu J, Fang S, Lu KT, Wackman K, Schwartzman ML, Dikalov SI, Grobe JL, Sigmund CD. EP3 (E-Prostanoid 3) Receptor Mediates Impaired Vasodilation in a Mouse Model of Salt-Sensitive Hypertension. Hypertension 2021; 77:1399-1411. [PMID: 33641369 DOI: 10.1161/hypertensionaha.120.16518] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jing Wu
- From the Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (J.W., S.F., K.-T.L., K.W., J.L.G., C.D.S.)
| | - Shi Fang
- From the Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (J.W., S.F., K.-T.L., K.W., J.L.G., C.D.S.).,Department of Pharmacology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa (S.F.)
| | - Ko-Ting Lu
- From the Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (J.W., S.F., K.-T.L., K.W., J.L.G., C.D.S.)
| | - Kelsey Wackman
- From the Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (J.W., S.F., K.-T.L., K.W., J.L.G., C.D.S.)
| | - Michal L Schwartzman
- Department of Pharmacology, New York Medical College School of Medicine, Valhalla (M.L.S.)
| | - Sergey I Dikalov
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (S.D.)
| | - Justin L Grobe
- From the Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (J.W., S.F., K.-T.L., K.W., J.L.G., C.D.S.)
| | - Curt D Sigmund
- From the Department of Physiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee (J.W., S.F., K.-T.L., K.W., J.L.G., C.D.S.)
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Horikawa C, Aida R, Tanaka S, Kamada C, Tanaka S, Yoshimura Y, Kodera R, Fujihara K, Kawasaki R, Moriya T, Yamashita H, Ito H, Sone H, Araki A. Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes-Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT). Nutrients 2021; 13:nu13020689. [PMID: 33670045 PMCID: PMC7926689 DOI: 10.3390/nu13020689] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/02/2022] Open
Abstract
This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.
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Affiliation(s)
- Chika Horikawa
- Department of Health and Nutrition, University of Niigata Prefecture Faculty of Human Life Studies, 471 Ebigase, Higashi-ku, Niigata 950-8680, Japan;
| | - Rei Aida
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; (R.A.); (S.T.)
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan; (R.A.); (S.T.)
| | - Chiemi Kamada
- Training Department of Administrative Dietitians, Shikoku University, 123-1 Ebisuno, Furukawa, Ojin-cho, Tokushima 771-1151, Japan; (C.K.); (Y.Y.)
| | - Sachiko Tanaka
- Department of Public Health, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Sihga 520-2192, Japan;
| | - Yukio Yoshimura
- Training Department of Administrative Dietitians, Shikoku University, 123-1 Ebisuno, Furukawa, Ojin-cho, Tokushima 771-1151, Japan; (C.K.); (Y.Y.)
| | - Remi Kodera
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan; (R.K.); (H.I.)
- Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuoh-ku, Niigata 951-8510, Japan; (K.F.); (H.S.)
| | - Kazuya Fujihara
- Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuoh-ku, Niigata 951-8510, Japan; (K.F.); (H.S.)
| | - Ryo Kawasaki
- Department of Vision Informatics, Graduate School of Medicine Faculty of Medicine, Osaka University, Osaka, 2-2 Yamadaoka, Suita 565-0871, Japan;
| | - Tatsumi Moriya
- Health Care Center, Kitasato University, 1-15-1, Kitazato, Minami-ku, Sagamihara-shi 252-0373, Japan;
| | - Hidetoshi Yamashita
- Department of Ophthalmology and Visual Science, Yamagata University Faculty of Medicine, 2-2-2 Iidanishi, Yamagata-shi 990-8560, Japan;
| | - Hideki Ito
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan; (R.K.); (H.I.)
| | - Hirohito Sone
- Department of Hematology, Endocrinology, and Metabolism, Niigata University Faculty of Medicine, 1-757 Asahimachi-dori, Chuoh-ku, Niigata 951-8510, Japan; (K.F.); (H.S.)
| | - Atsushi Araki
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan; (R.K.); (H.I.)
- Correspondence: ; Tel.: +81-03-3964-1141; Fax: +81-03-3964-1982
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24
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Huang Z, Zeng D. Factors Affecting Salt Reduction Measure Adoption among Chinese Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020445. [PMID: 33429901 PMCID: PMC7827444 DOI: 10.3390/ijerph18020445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/03/2022]
Abstract
China has the highest mortality rate caused by diseases and conditions associated with its high-salt diet. Since 2016, China has initiated a national salt reduction campaign that aims at promoting the usage of salt information on food labels and salt-restriction spoons and reducing condiment and pickled food intake. However, factors affecting individuals’ decisions to adopt these salt reduction measures remain largely unknown. By comparing the performances of logistic regression, stepwise logistic regression, lasso logistic regression and adaptive lasso logistic regression, this study aims to fill this gap by analyzing the adoption behaviour of 1610 individuals from a nationally representative online survey. It was found that the practices were far from adopted and only 26.40%, 22.98%, 33.54% and 37.20% reported the adoption of labelled salt information, salt-restriction spoons, reduced condiment use in home cooking and reduced pickled food intake, respectively. Knowledge on salt, the perceived benefits of salt reduction, participation in nutrition education and training programs on sodium reduction were positively associated with using salt information labels. Adoption of the other measures was largely explained by people’s awareness of hypertension risks and taste preferences. It is therefore recommended that policy interventions should enhance Chinese individuals’ knowledge of salt, raise the awareness of the benefits associated with a low-salt diet and the risks associated with consuming excessive salt and reshape their taste choices.
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Affiliation(s)
- Zeying Huang
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
- Correspondence: ; Tel.: +86-13716627967
| | - Di Zeng
- Centre for Global Food and Resources, The University of Adelaide, Adelaide, SA 5005, Australia;
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25
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Clinical Profiles and Factors Associated with a Low Sodium Intake in the Population: An Analysis of the Swiss Survey on Salt. Nutrients 2020; 12:nu12113591. [PMID: 33238516 PMCID: PMC7700385 DOI: 10.3390/nu12113591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/16/2022] Open
Abstract
As a part of the salt controversy, it has been suggested that people with a low sodium intake have an increased risk of cardiovascular events. However, there is no clear explanation for this increased risk. We examined the socio-demographic, clinical profile, and behavioral factors associated with a low sodium intake in the Swiss subjects who participated in the Swiss Survey on Salt. Only 13.3% of the Swiss population eat less than 5 g of salt daily and among them 78.2% are women. Subjects with a low sodium intake eat and drink less as reflected by lower intakes of proteins, potassium, and calcium and a smaller urine volume. In addition, a low blood pressure, a normal body mass index, a low prevalence of obesity, a low serum uric acid, and less alcohol and cigarette consumption characterized this group, suggesting a rather low cardiovascular risk profile. Being single and doing most of the cooking at home are associated with a low intake of sodium, as well as a less frequent consumption of meat and fish when eating less than 5 g salt per day. However, the awareness of the effects of salt on health and cardiovascular risk, health concerns, and physical activity are similar in subjects eating more or less salt. In conclusion, we could not evidence clinical or behavioral factors that could significantly increase the risk of developing cardiovascular events in low salt eaters.
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Faulkner JL, Belin de Chantemèle EJ. Female Sex, a Major Risk Factor for Salt-Sensitive Hypertension. Curr Hypertens Rep 2020; 22:99. [PMID: 33089375 PMCID: PMC7675065 DOI: 10.1007/s11906-020-01113-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW High dietary salt is a significant contributor to essential hypertension in clinical populations. However, although clinical studies indicate a higher prevalence of salt sensitivity in women over men, knowledge of salt-sensitive mechanisms is largely restricted to males, and female-specific mechanisms are presently being elucidated. RECENT FINDINGS Male-specific mechanisms of salt-sensitive hypertension are well published and predominantly appear to involve dysfunctional renal physiology. However, emerging novel evidence indicates that aldosterone production is sex-specifically heightened in salt-sensitive hypertensive women and female rodent models, which may be regulated by intra-adrenal renin-angiotensin system activation and sex hormone receptors. In addition, new evidence that young females endogenously express higher levels of endothelial mineralocorticoid receptors (MRs) and that endothelial MR is a crucial mediator of endothelial dysfunction in females indicates that the aldosterone-endothelial MR activation pathway is a novel mediator of salt-sensitive hypertension. Heightened aldosterone levels and endothelial MR expression provide a 2-fold sex-specific mechanism that may underlie the pathology of salt-sensitive hypertension in women. This hypothesis indicates that MR antagonists may be a preferential treatment for premenopausal women diagnosed with salt-sensitive hypertension.
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Affiliation(s)
- Jessica L Faulkner
- Vascular Biology Center, Medical College of Georgia at Augusta University, 1460 Laney Walker Blvd., Augusta, GA, 30912, USA
| | - Eric J Belin de Chantemèle
- Vascular Biology Center, Medical College of Georgia at Augusta University, 1460 Laney Walker Blvd., Augusta, GA, 30912, USA.
- Department of Medicine (Cardiology), Medical College of Georgia at Augusta University, 1460 Laney Walker Blvd., Augusta, GA, 30912, USA.
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Fayet-Moore F, Wibisono C, Carr P, Duve E, Petocz P, Lancaster G, McMillan J, Marshall S, Blumfield M. An Analysis of the Mineral Composition of Pink Salt Available in Australia. Foods 2020; 9:E1490. [PMID: 33086585 PMCID: PMC7603209 DOI: 10.3390/foods9101490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/16/2022] Open
Abstract
Little is known about the mineral composition of pink salt. The aim of this study was to evaluate for the first time the mineral composition of pink salt available for purchase in Australia and its implications for public health. Pink salt samples were purchased from retail outlets in two metropolitan Australian cities and one regional town. Color intensity, salt form, and country of origin were coded. A mass spectrometry scan in solids was used to determine the amount of 25 nutrients and non-nutritive minerals in pink salt (n = 31) and an iodized white table salt control (n = 1). A wide variation in the type and range of nutrients and non-nutritive minerals across pink salt samples were observed. One pink salt sample contained a level of lead (>2 mg/kg) that exceeded the national maximum contaminant level set by Food Standards Australia New Zealand. Pink salt in flake form, pink salt originating from the Himalayas, and darker colored pink salt were generally found to contain higher levels of minerals (p < 0.05). Despite pink salt containing nutrients, >30 g per day (approximately 6 teaspoons) would be required to make any meaningful contribution to nutrient intake, a level that would provide excessive sodium and potential harmful effects. The risk to public health from potentially harmful non-nutritive minerals should be addressed by Australian food regulations. Pink salt consumption should not exceed the nutrient reference values for Australia and New Zealand guidelines of <5 g of salt per day.
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Affiliation(s)
- Flavia Fayet-Moore
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Cinthya Wibisono
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Prudence Carr
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Emily Duve
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Peter Petocz
- Department of Statistics, Macquarie University, Sydney 2109, Australia;
| | - Graham Lancaster
- Environmental Analysis Laboratory, Southern Cross University, Lismore 2480, Australia;
| | - Joanna McMillan
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora Victoria 3086, Australia;
| | - Skye Marshall
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Michelle Blumfield
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
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Koç Ş, Baysal SS. Practical Method for Salt Intake Follow-Up in Hypertensive Patients. Metab Syndr Relat Disord 2020; 18:353-361. [PMID: 32580624 DOI: 10.1089/met.2020.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Obese and hypertensive (HT) patients should restrict salt intake. In excessive salt intake, ouabain-like compounds inhibit Na/K-ATPase (Na+ pump), which increases intracellular Na+ and Ca2+. Ca2+ has a vasotonic effect on arteries and an inotropic effect on the heart and may cause cortical opacities in the lens. To our knowledge, there is still no practical method for salt intake follow-up. This study tested whether salt intake follow-up can be performed with the help of opacity tracking. Methods: In total, 400 HT patients (age 30-69 years) with cortical lens opacities were included in the study. Changes in opacities based on biomicroscopic examination at baseline and after 3 months were recorded digitally with the help of imaging software. Salt intake at 1 and 3 months was evaluated with a 24-hr urine Na assay. Changes in opacities were compared among group 1 (∼50% salt reduction), group 2 (∼10% salt reduction), and group 3 (∼15% salt increase). Results: Age and changes in small opacity diameter (SOD) and large opacity diameter (LOD) were the most important determinants of the 50% salt reduction in the third month. For changes in LOD, the sensitivity was 88.5% [confidence interval (95% CI) 85.2-91.7] and specificity was 95.5% (95% CI 93.1-98.7) for predicting a 50% salt restriction during the 3-month period. For SOD, the values were 85% (95% CI 82.5-87) and 95% (95% CI 92.3-97.5), respectively. Conclusions: Opacity changes are a practical method for predicting a 50% reduction in salt intake over a 3-month period in 30- to 59-year-old HT patients.
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Affiliation(s)
- Şahbender Koç
- Department of Cardiology, University of Health Sciences. Keçiören Education and Training Hospital, Ankara, Turkey
| | - Sadettin Selçuk Baysal
- Department of Cardiology, University of Health Sciences, Şanlıurfa Mehmet Akif İnan Education and Training Hospital, Urfa, Turkey
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Abstract
PURPOSE OF REVIEW Hypertension affects approximately 10% of pregnancies and may persist in the postpartum period. Furthermore, de novo hypertension may present after delivery, but its exact prevalence is not verified. Both types of hypertension expose the mother to eventually severe complications like eclampsia, stroke, pulmonary edema, and HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome. RECENT FINDINGS Until today, there are limited data regarding the risk factors, pathogenesis, and pathophysiology of postpartum hypertensive disorders. However, there is certain evidence that preeclampsia may in large part be responsible. Women who experienced preeclampsia during pregnancy, although considered cured after delivery and elimination of the placenta, continue to present endothelial and renal dysfunction in the postpartum period. The brain and kidneys are particularly sensitive to this pathological vascular condition, and severe complications may result from their involvement. Large randomized trials are needed to give us the evidence that will allow a timely diagnosis and treatment. Until then, medical providers should increase their knowledge regarding hypertension after delivery because many times there is an underestimation of the complications that can ensue after a misdiagnosed or undertreated postpartum hypertension.
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Affiliation(s)
- V Katsi
- Cardiology Department, Hippokration Hospital, Athens, Greece
| | - G Skalis
- Department of Cardiology, Helena Venizelou Hospital, Athens, Greece.
| | - G Vamvakou
- Department of Cardiology, Helena Venizelou Hospital, Athens, Greece
| | - D Tousoulis
- 1st Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - T Makris
- Department of Cardiology, Helena Venizelou Hospital, Athens, Greece
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30
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Baqar S, Kong YW, Chen AX, O'Callaghan C, MacIsaac RJ, Bouterakos M, Lambert GW, Jerums G, Lambert EE, Ekinci EI. Effect of Salt Supplementation on Sympathetic Activity and Endothelial Function in Salt-Sensitive Type 2 Diabetes. J Clin Endocrinol Metab 2020; 105:5639695. [PMID: 31761946 DOI: 10.1210/clinem/dgz219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 11/23/2019] [Indexed: 12/22/2022]
Abstract
CONTEXT Lower sodium intake is paradoxically associated with higher mortality in type 2 diabetes (T2D). OBJECTIVE To determine whether sympathetic nervous system (SNS) activation and endothelial dysfunction contribute to these observations, we examined the effect of salt supplementation on these systems in people with T2D with habitual low sodium. We hypothesized that salt supplementation would lower SNS activity and improve endothelial function compared to placebo. DESIGN We conducted a randomized, double-blinded, placebo-controlled crossover trial. SETTING The study took place in a tertiary referral diabetes outpatient clinic. PARTICIPANTS Twenty-two people with T2D with habitual low sodium intake (24-hour urine sodium <150 mmol/24h) were included. INTERVENTION Salt supplementation (100 mmol NaCl/24h) or placebo for 3 weeks was administered. MAIN OUTCOME MEASURES The primary outcome of SNS activity and endothelial function was assessed as follows: Microneurography assessed muscle sympathetic nerve activity (MSNA), pulse amplitude tonometry assessed endothelial function via reactive hyperemic index (RHI), and arterial stiffness was assessed via augmentation index (AI). Secondary outcomes included cardiac baroreflex, serum aldosterone, ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV), and salt sensitivity. RESULTS Compared to placebo, salt supplementation increased MSNA (burst frequency P = .047, burst incidence P = .016); however, RHI (P = .24), AI (P = .201), ABPM (systolic P = .09, diastolic P = .14), and HRV were unaffected. Salt supplementation improved baroreflex (slope P = .026) and lowered aldosterone (P = .004), and in salt-resistant individuals there was a trend toward improved RHI (P = .07). CONCLUSIONS In people with T2D and low habitual sodium intake, salt supplementation increased SNS activity without altering endothelial function or blood pressure but improved baroreflex function, a predictor of cardiac mortality. Salt-resistant individuals trended toward improved endothelial function with salt supplementation.
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Affiliation(s)
- Sara Baqar
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Yee Wen Kong
- Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Angela X Chen
- Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
| | | | - Richard J MacIsaac
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
- Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne and The University of Melbourne, Fitzroy, Victoria, Australia
| | - Maree Bouterakos
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Gavin W Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - George Jerums
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Elisabeth E Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Elif I Ekinci
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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Jiang X, Liu X, Liu X, Wu X, Jose PA, Liu M, Yang Z. Low-Dose Aspirin Treatment Attenuates Male Rat Salt-Sensitive Hypertension via Platelet Cyclooxygenase 1 and Complement Cascade Pathway. J Am Heart Assoc 2020; 9:e013470. [PMID: 31852420 PMCID: PMC6988172 DOI: 10.1161/jaha.119.013470] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/29/2019] [Indexed: 12/15/2022]
Abstract
Background The role of platelets in the development of vascular inflammation and endothelial dysfunction in the pathogenesis of hypertension is well established at this time. Aspirin is known to relieve pain, decrease fever, reduce inflammation, impair platelet aggregation, and prevent clotting, yet its effect in the context of salt-sensitive hypertension remains unclear. The present study investigated the importance of aspirin in inhibiting the abnormal activation of platelets and promoting the normal function of the vascular endothelium in a rat model of salt-sensitive hypertension. Method and Results Dahl salt-sensitive rats and salt-resistant rats were fed a normal-salt diet (4% NaCl), a high-salt diet (8% NaCl), or a high-salt diet with aspirin gavage (10 mg/kg per day) for 8 weeks. Blood pressure, platelet activation, vascular function, inflammatory response, and potential mechanism were measured. Low-dose aspirin (10 mg/kg per day) decreased the high-salt diet-induced elevation of blood pressure, platelet activation, leukocyte infiltration, and leukocyte-platelet aggregation (CD45+CD61+), as well as vascular endothelial and renal damage. These effects were related to the ability of aspirin to prevent the adhesion of leukocytes to endothelial cells via inhibition of the platelet cyclooxygenase 1 but not the cyclooxygenase 2 pathway. Aspirin also reversed the high-salt diet-induced abnormal activation of complement and coagulation cascades in platelets. Conclusions These results highlight a new property of aspirin in ameliorating vascular endothelial dysfunction induced by platelet activation, which may be beneficial in the treatment of salt-sensitive hypertension.
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Affiliation(s)
- Xiaoliang Jiang
- NHC Key Laboratory of Human Disease Comparative Medicine (The Institute of Laboratory Animal Sciences CAMS&PUMC)BeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
| | - Xue Liu
- NHC Key Laboratory of Human Disease Comparative Medicine (The Institute of Laboratory Animal Sciences CAMS&PUMC)BeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
| | - Xing Liu
- NHC Key Laboratory of Human Disease Comparative Medicine (The Institute of Laboratory Animal Sciences CAMS&PUMC)BeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
| | - Xianxian Wu
- NHC Key Laboratory of Human Disease Comparative Medicine (The Institute of Laboratory Animal Sciences CAMS&PUMC)BeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
| | - Pedro A. Jose
- Division of Kidney Diseases & HypertensionDepartment of MedicineThe George Washington University School of Medicine & Health SciencesWashingtonDC
- Department of Pharmacology and PhysiologyThe George Washington University School of Medicine & Health SciencesWashingtonDC
| | - Min Liu
- Department of HypertensionHenan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhouChina
| | - Zhiwei Yang
- NHC Key Laboratory of Human Disease Comparative Medicine (The Institute of Laboratory Animal Sciences CAMS&PUMC)BeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
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32
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Cuevas S, Asico LD, Jose PA, Konkalmatt P. Renal Hydrogen Peroxide Production Prevents Salt-Sensitive Hypertension. J Am Heart Assoc 2020; 9:e013818. [PMID: 31902320 PMCID: PMC6988155 DOI: 10.1161/jaha.119.013818] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
Abstract
Background The regulation of sodium excretion is important in the pathogenesis of hypertension and salt sensitivity is predictive of cardiovascular events and mortality. C57Bl/6 and BALB/c mice have different blood pressure sensitivities to salt intake. High salt intake increases blood pressure in some C57Bl/6J mouse strains but not in any BALB/c mouse strain. Methods and Results We determined the cause of the difference in salt sensitivity between C57Bl/6 and BALB/c mice. Basal levels of superoxide and H2O2 were higher in renal proximal tubule cells (RPTCs) from BALB/c than C57Bl/6J mice. High salt diet increased H2O2 production in kidneys from BALB/c but C57Bl/6J mice. High sodium concentration (170 mmol/L) in the incubation medium increased H2O2 levels in BALB/c-RPTCs but not in C57Bl/6J-RPTCs. H2O2 (10 μmol/L) treatment decreased sodium transport in RPTCs from BALB/c but not C57Bl/6J mice. Overexpression of catalase in the mouse kidney predisposed BALB/c mice to salt-sensitive hypertension. Conclusions Our data show that the level of salt-induced H2O2 production negatively regulates RPTC sodium transport and determines the state of salt sensitivity in 2 strains of mice. High concentrations of antioxidants could prevent H2O2 production in renal proximal tubules, which would result in sodium retention and increased blood pressure.
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Affiliation(s)
- Santiago Cuevas
- Division of Renal Diseases & HypertensionDepartment of MedicineThe George Washington University School of Medicine and Health SciencesWashingtonDC
| | - Laureano D. Asico
- Division of Renal Diseases & HypertensionDepartment of MedicineThe George Washington University School of Medicine and Health SciencesWashingtonDC
| | - Pedro A. Jose
- Division of Renal Diseases & HypertensionDepartment of MedicineThe George Washington University School of Medicine and Health SciencesWashingtonDC
| | - Prasad Konkalmatt
- Division of Renal Diseases & HypertensionDepartment of MedicineThe George Washington University School of Medicine and Health SciencesWashingtonDC
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Zou X, Wang J, Chen C, Tan X, Huang Y, Jose PA, Yang J, Zeng C. Secreted Monocyte miR-27a, via Mesenteric Arterial Mas Receptor-eNOS Pathway, Causes Hypertension. Am J Hypertens 2020; 33:31-42. [PMID: 31328772 DOI: 10.1093/ajh/hpz112] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/09/2019] [Accepted: 07/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Essential hypertension is associated with increased plasma concentrations of extracellular vesicles (EVs). We aimed to determine the role of monocyte miR-27a in EVs on arterial Mas receptor expression, and its involvement in the pathogenesis of hypertension. METHODS THP-1 cells were transfected with miR-27a mimic and miR-27a inhibitor, and EVs were collected. Mas receptor expression and endothelial nitric oxide synthase (eNOS) phosphorylation were determined by immunoblotting. Sprague-Dawley (SD) rats received EVs via tail-vein injection. Blood pressure (BP) was measured with the tail-cuff method. The vasodilatory response of mesenteric arteries was measured using a small vessel myograph. RESULTS EVs from THP-1 cells increased rat BP by impairing Ang-(1-7)-mediated vasodilation in mesenteric arteries, which was further exaggerated by EVs from lipopolysaccharides-treated THP-1 cells. As the receptor and key signaling of Ang-(1-7), next experiments found that Mas receptor expression and eNOS phosphorylation were decreased in mesenteric arteries from EVs-treated SD rats. Screening studies found miR-27a in EVs may be involved in this process. Through transfection with miR-27a inhibitor or miR-27a mimic, we found that miR-27a downregulates Mas receptor expression in endothelial cells. Injection of EVs from miR-27a-transfected HEK-293 cells decreased Mas receptor and eNOS phosphorylation in mesenteric arteries, impaired Ang-(1-7)-mediated vasodilation and increased BP. Earlier effects were reversed using cells with downregulation of miR-27 in EVs. CONCLUSIONS Monocyte miR-27a in EVs decreases Mas receptor expression and eNOS phosphorylation in endothelium, impairs Ang-(1-7)-mediated vasodilation, and causes hypertension. Understanding the contributions of EVs in the pathogenesis of hypertension may facilitate their use as a diagnostic biomarker.
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Affiliation(s)
- Xue Zou
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
- Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, P.R. China
| | - Jialiang Wang
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
- Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, P.R. China
| | - Caiyu Chen
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
- Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, P.R. China
| | - Xiaorong Tan
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
- Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, P.R. China
| | - Yu Huang
- Institute of Vascular Medicine and Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, P.R. China
| | - Pedro A Jose
- Division of Renal Disease and Hypertension, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jian Yang
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China
| | - Chunyu Zeng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, P.R. China
- Chongqing Institute of Cardiology and Chongqing Key Laboratory for Hypertension Research, Chongqing, P.R. China
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Current Data on Dietary Sodium, Arterial Structure and Function in Humans: A Systematic Review. Nutrients 2019; 12:nu12010005. [PMID: 31861381 PMCID: PMC7019233 DOI: 10.3390/nu12010005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/03/2019] [Accepted: 12/09/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Worldwide, sodium (Na) intake is almost double international recommendations and has been linked with CVD and death, although in a J-shape manner. Studies regarding dietary Na and major types of SAD may provide pathophysiological insight into the association between Na and CVD. Objectives: Systematic review of data derived from observational and interventional studies in humans, investigating the association between dietary Na with (i) atheromatosis (arterial plaques); (ii) arteriosclerosis (various biomarkers of arterial stiffness); (iii) arterial remodeling (intima–media thickening and arterial lumen diameters). Data sources: Applying the PRISMA criteria, the PubMed and Scopus databases were used. Results: 36 studies were included: 27 examining arteriosclerosis, four arteriosclerosis and arterial remodeling, three arterial remodeling, and two arterial remodeling and atheromatosis. Conclusions: (i) Although several studies exist, the evidence does not clearly support a clinically meaningful and direct (independent from blood pressure) effect of Na on arterial wall stiffening; (ii) data regarding the association of dietary Na with arterial remodeling are limited, mostly suggesting a positive trend between dietary Na and arterial hypertrophy but still inconclusive; (iii) as regards to atheromatosis, data are scarce and the available studies present high heterogeneity. Further state-of-the-art interventional studies must address the remaining controversies.
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Andersson C, Lin H, Liu C, Levy D, Mitchell GF, Larson MG, Vasan RS. Integrated Multiomics Approach to Identify Genetic Underpinnings of Heart Failure and Its Echocardiographic Precursors. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019; 12:e002489. [DOI: 10.1161/circgen.118.002489] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background:
Heart failure (HF) may arise from alterations in metabolic, structural, and signaling pathways, but its genetic architecture is incompletely understood. To elucidate potential genetic contributors to cardiac remodeling and HF, we integrated genome-wide single-nucleotide polymorphisms, gene expression, and DNA methylation using a transomics analytical approach.
Methods:
We used robust rank aggregation (where the position of a certain gene in a rank order list [based on statistical significance level] is tested against a randomly shuffled rank order list) to derive an integrative transomic score for each annotated gene associated with a HF trait.
Results:
We evaluated ≤8372 FHS (Framingham Heart Study) participants (54% women; mean age, 55±17 years). Of these, 62 (0.7%) and 35 (0.4%) had prevalent HF with reduced ejection fraction and HF with preserved left ventricular ejection fraction, respectively. During a mean follow-up of 8.5 years (minimum–maximum, 0.005–18.6 years), 223 (2.7%) and 234 (2.8%) individuals developed incident HF with reduced ejection fraction and HF with reduced ejection fraction, respectively. Top genes included
MMP20
and
MTSS1
(promotes actin assembly at intercellular junctions) for left ventricular systolic function;
ITGA9
(receptor for
VCAM1
[vascular cell protein 1]) and
C5
for left ventricular remodeling;
NUP210
(expressed during myogenic differentiation) and
ANK1
(cytoskeletal protein) for diastolic function;
TSPAN16
and
RAB11FIP3
(involved in regulation of actin cytoskeleton) for prevalent HF with reduced ejection fraction;
ANKRD13D
and
TRIM69
for incident HF with reduced ejection fraction;
HPCAL1
and
PTTG1IP
for prevalent HF with reduced ejection fraction; and
ZNF146
(close to the
COX7A1
enzyme) and
ZFP3
(close to
SLC52A1
—the riboflavin transporter) for incident HF with reduced ejection fraction. We tested the HF-related top single-nucleotide polymorphisms in the UK biobank, where
rs77059055
in
TPM1
(minor allele frequency, 0.023; odds ratio, 0.83;
P
=0.002) remained statistically significant upon Bonferroni correction.
Conclusions:
Our integrative transomics approach offers insights into potential molecular and genetic contributors to HF and its precursors. Although several of our candidate genes have been implicated in HF in animal models, independent replication is warranted.
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Affiliation(s)
- Charlotte Andersson
- Framingham Heart Study, MA (C.A., H.L., C.L., D.L., M.G.L., R.S.V.)
- Department of Cardiology, Herlev and Gentofte Hospital, Herlev, Denmark (C.A.)
| | - Honghuang Lin
- Framingham Heart Study, MA (C.A., H.L., C.L., D.L., M.G.L., R.S.V.)
- Section of Computational Biomedicine, Department of Medicine (H.L.), Boston University School of Medicine, MA
| | - Chunyu Liu
- Framingham Heart Study, MA (C.A., H.L., C.L., D.L., M.G.L., R.S.V.)
- Department of Biostatistics (C.L., M.G.L.), Boston University School of Public Health, MA
| | - Daniel Levy
- Framingham Heart Study, MA (C.A., H.L., C.L., D.L., M.G.L., R.S.V.)
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (D.L.)
| | | | - Martin G. Larson
- Framingham Heart Study, MA (C.A., H.L., C.L., D.L., M.G.L., R.S.V.)
- Department of Biostatistics (C.L., M.G.L.), Boston University School of Public Health, MA
| | - Ramachandran S. Vasan
- Framingham Heart Study, MA (C.A., H.L., C.L., D.L., M.G.L., R.S.V.)
- Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine (R.S.V.), Boston University School of Medicine, MA
- Department of Epidemiology (R.S.V.), Boston University School of Public Health, MA
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Frame AA, Farquhar WB, Latulippe ME, McDonough AA, Wainford RD, Wynne BM. Moving the Needle on Hypertension: What Knowledge Is Needed? NUTRITION TODAY 2019; 54:248-256. [PMID: 34092814 PMCID: PMC8174552 DOI: 10.1097/nt.0000000000000375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This review highlights the gaps in knowledge and methodological challenges discussed during the Experimental Biology 2019 expert panel session titled "Moving the Needle on Hypertension: What Knowledge Is Needed?" Hypertension is a critical public health burden. Despite a demonstrated benefit of blood pressure reduction on measures of hypertension-related morbidity and mortality, rates for successful blood pressure control remain low. Dietary sodium reduction has been shown to reduce both systolic blood pressure by approximately 3.2 mm Hg and diastolic blood pressure by 2.3 mm Hg, depending on baseline blood pressure and degree of sodium reduction. The updated Dietary Reference Intakes for adults released by the National Academies of Sciences, Engineering, and Medicine include a Chronic Disease Risk Reduction sodium intake level of 2300 mg/d, highlighting the importance of dietary sodium intake in reducing elevated blood pressure and indicating that reducing intakes to this level is expected to reduce blood pressure and risk of cardiovascular disease. The average US daily sodium intake of 3400 mg/d is well above the Chronic Disease Risk Reduction of 2300 mg/d, suggesting that dietary sodium reduction has the potential to significantly improve public health. Although the National Academies of Sciences, Engineering, and Medicine report presents intake recommendations based on a systematic, comprehensive, and thorough evaluation of the evidence, several challenges to moving the needle on hypertension remain. Success will require a more advanced understanding of sodium and potassium physiology, as well as development of the tools needed to effectively address existing research gaps and reduce barriers to sodium intake reduction.
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Affiliation(s)
- Alissa A Frame
- Boston University School of Medicine, Boston, Massachusetts
| | - William B Farquhar
- College of Health Sciences at the University of Delaware, Newark, Delaware
| | | | - Alicia A McDonough
- University of Southern California Keck School of Medicine, Los Angeles, California
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Ding L, Cheng P, Wang L, Hu J, Zhang YX, Cai GW, Huang GY, Gao S. The protective effects of polysaccharide extract from Xin-Ji-Er-Kang formula on Ang II-induced HUVECs injury, L-NAME-induced hypertension and cardiovascular remodeling in mice. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:127. [PMID: 31196042 PMCID: PMC6567637 DOI: 10.1186/s12906-019-2539-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/03/2019] [Indexed: 11/12/2022]
Abstract
Background Xin-Ji-Er-Kang (XJEK) is a Chinese herbal formula, which has been reported to exert effective protection against cardiovascular diseases, including hypertension and myocarditis. Methods Cultured human umbilical vascular endothelial cells (HUVECs) were treated with angiotensin II (Ang II) and different concentrations of aqueous layer extracts (AqE). Subsequently nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) expression levels were detected. In addition, fifty Kunming mice were randomized into control, Nω-nitro-L-arginine methyl ester (L-NAME), L-NAME+AqE, L-NAME+XJEK and L-NAME+fosinopril treatment groups. Following 8 weeks of treatment, the cardiac hemodynamic index was measured, relaxation of the aorta was examined and pathological changes were observed. Colorimetric analysis and enzyme linked immunosorbent assay (ELISA) were applied to determine the relevant indicators in plasma and cardiac tissues. Results The in vitro study results demonstrated that AqE could preserve endothelial function (NO, 21.05 ± 2.03 vs. 8.64 ± 0.59; eNOS, 1.08 ± 0.17 vs.0.73 ± 0.06). In addition, the in vivo results demonstrated that compared with the control group, treatment with AqE could enhance a high hemodynamic state (left ventricular systolic pressure, 116.76 ± 9.96 vs.114.5 ± 15.16), improve endothelial function (NO, 7.98 ± 9.64 vs. 1.66 ± 3.11; eNOS, 19.78 ± 3.18 vs.19.38 ± 3.85), suppress oxidative stress (OS) (superoxide dismutase, 178.17 ± 13.78 vs. 159.38 ± 18.86; malondialdehyde, 0.77 ± 0.13 vs.1.25 ± 0.36) and reverse cardiovascular remodeling. Conclusion Polysaccharide from XJEK exerts protective effects against Ang II-induced injury in HUVECs and L-NAME-induced hypertension in mice and the underlying mechanism may be attributed to improving endothelial dysfunction, OS and the inflammation status in mice.
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Oloyo AK, Imaga NO, Fatope Y, Sofola OA. Sex differences in cardiac and renal responses to a high salt diet in Sprague-Dawley rats. Heliyon 2019; 5:e01665. [PMID: 31193051 PMCID: PMC6514751 DOI: 10.1016/j.heliyon.2019.e01665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 04/09/2019] [Accepted: 05/02/2019] [Indexed: 01/11/2023] Open
Abstract
High dietary salt intake is an important risk factor for cardiovascular and renal diseases. However, sexual disparity exists in the response of target organs to high salt diet (HSD). To determine how sex affects cardiac and renal functions' response to HSD, 20 weanling Sprague-Dawley rats (10 males and 10 females) were divided into 4 groups of 5 rats each. The rats were fed a normal diet (0.3% NaCl) or HSD (8% NaCl) for 12 weeks. Fluid balance (FB) was determined from 24 hrs water intake and voided urine. Blood pressure (BP) was measured via arterial cannulation under anesthesia (25% w/v urethane and 1% w/v α-chloralose; 5 ml/kg, i.p). Serum levels of troponin I, aminotransaminases, creatinine, urea, uric acid and electrolytes as well as urinary concentration of albumin, creatinine, and electrolytes were measured using appropriate assay kits. Values are presented as mean ± S.E.M, compared by two-way ANOVA and Bonferroni post Hoc test. In the male rat, HSD significantly increased BP, serum: Troponin I, LDH and sodium (p < 0.05), urinary: albumin, sodium, potassium and FB (p < 0.05). In the female rat, HSD increased BP, serum: troponin I, LDH, sodium and creatinine clearance (p < 0.05), urinary: albumin, sodium and potassium (p < 0.01). However, HSD increased more, the BP, serum: Troponin I, LDH, urinary albumin and FB in male rats, while HSD increased urinary sodium more in female rats. Basal values in male vs. female of serum LDH and urinary albumin were significantly different. Thus, sex plays an important role in the response of the heart and kidney to salt stress.
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Affiliation(s)
- Ahmed Kolade Oloyo
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
| | - Ngozi O.A. Imaga
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
| | - Yemisi Fatope
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
| | - Olusoga A. Sofola
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
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Abstract
BACKGROUND Salt is important in the pathogenesis of hypertension (HT). Salt-sensitive hypertension (SSH) accounts for about half of all HT cases. In SSH, sodium/potassium adenosine triphosphatase (Na+/K+-ATPase) activity is impaired. Impaired Na+/K+-ATPase activity in the lens epithelium results in cortical opacities in the peripheral equator of the lens. We investigated the sensitivity of cortical lens opacities in detecting SSH. METHODS The study included 191 SSH and 159 non-SSH, salt-resistant HT (SRH) patients (350 HT patients total), aged 40-80 years. One hundred twenty-four sex- and age-matched patients without a HT diagnosis made up the control group. Daily salt intake of all groups was calculated from 24-hr urinary Na excretion. SSH was diagnosed when the difference in mean arterial blood pressure values obtained during high- and low-Na diets was ≥10%. Non-SSH, SRH was diagnosed when the difference was <10%.Two researchers examined the presence of cortical lens opacities biomicroscopically using the diffuse, direct, Scheimpflug, and retroillumination from fundus methods. RESULTS Total lens opacity was predictive of SSH among all cases (P < 0.001), with a sensitivity and specificity of 75.4% [95% confidence interval (CI): 68.6-81.3] and 83.6% (95% CI: 77.0-89.0), respectively. Its positive and negative predictive values were 84.7% (95% CI: 79.4-88.8) and 73.9% (95% CI: 68.6-78.5), respectively. CONCLUSIONS Lens opacities can be used as a finding that can be easily observed in the detection of SSH and excess salt intake.
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Affiliation(s)
- Şahbender Koç
- 1 Keçiören Education and Training Hospital, University of Health Sciences, Ankara, Turkey
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40
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Oral Fludrocortisone Test for Salt-Sensitive Screening in Hypertensive Patients: A Randomized Crossover Trial. Int J Hypertens 2018; 2018:7437858. [PMID: 30581606 PMCID: PMC6276467 DOI: 10.1155/2018/7437858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/24/2018] [Accepted: 11/04/2018] [Indexed: 11/25/2022] Open
Abstract
Background Salt sensitivity is associated with an increased cardiovascular risk, but the gold standard method (diet cycles) requires 24-h urine samples and has poor patient compliance. Objectives Test the hypothesis that oral fludrocortisone (0.4 mg per day for 7 days) is a good alternative in identifying salt-sensitive patients. Methodology We conducted a randomized crossover study with 30 hypertensive individuals comprising the following steps: (1) washout; (2) phase A (low- and high-sodium diet cycles); (3) washout 2; (4) phase B (fludrocortisone test). Phase A and B steps were performed in a random way. Consistent with the literature, we found that 53.3% were salt-sensitive according to the reference test. Using the ROC curve, the fludrocortisone test defined salt sensitivity by a median blood pressure increase of ≥3 mmHg. A good accuracy of fludrocortisone in detecting salt sensitivity was observed (AUC: 0.732±0.065; p<0.001), with 80% sensitivity and 53% specificity. Conclusion The fludrocortisone test is a good option for screening salt sensitivity in hypertensive patients. However, the low specificity prevents this test from being an ideal substitute to the labor-intensive diet cycles exam in the definition of salt sensitivity. This clinical trial is registered with NCT01453959.
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Differential effects of arterial stiffness and fluid overload on blood pressure according to renal function in patients at risk for cardiovascular disease. Hypertens Res 2018; 42:341-353. [DOI: 10.1038/s41440-018-0151-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 12/30/2022]
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Faulkner JL, Harwood D, Bender L, Shrestha L, Brands MW, Morwitzer MJ, Kennard S, Antonova G, de Chantemèle EJB. Lack of Suppression of Aldosterone Production Leads to Salt-Sensitive Hypertension in Female but Not Male Balb/C Mice. Hypertension 2018; 72:1397-1406. [PMID: 30571230 PMCID: PMC6309424 DOI: 10.1161/hypertensionaha.118.11303] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Clinical studies indicate that salt-sensitive hypertension is more prevalent in women than in men. However, animal models of salt sensitivity have primarily focused on the mechanisms of salt sensitivity in male animals; therefore, elucidation of these mechanisms in female animal models is needed. We have previously shown that female Balb/C mice have higher aldosterone synthase expression and aldosterone production than males. We hypothesized that female Balb/C mice develop salt-sensitive increases in blood pressure. Seven-day feeding of a 4% NaCl high-salt (HS) diet increased blood pressure in female mice without altering blood pressure in males. Females on an HS diet displayed no apparent increases in sodium retention as assessed by 24-hour urine collection, sodium balance measure, and saline loading excretion analysis. Females on an HS diet exhibited lower renin-angiotensin system activity (plasma Ang II [angiotensin II], plasma renin activity, and ACE [angiotensin-converting enzyme] activity) compared with males but developed a salt-induced elevation in adrenal aldosterone synthase expression and retained higher aldosterone levels than males on HS. This resulted in a higher aldosterone/plasma renin activity ratio in females compared with males on HS feeding. Adrenal mRNA expression of angiotensinogen and leptin receptor was increased in female mice on an HS diet. HS impaired endothelium-dependent relaxation in female mice only. MR (mineralocorticoid receptor) inhibition (eplerenone) restored blood pressure and endothelial function in females on an HS diet. Collectively, these data indicate that Balb/C mice develop sex-discrepant salt-sensitive hypertension likely via aldosterone-MR-mediated mechanisms involving impaired endothelium-dependent relaxation in females only. This study presents the first model of spontaneous sex-specific salt sensitivity, which mimics the human pathology.
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Affiliation(s)
- Jessica L Faulkner
- Vascular Biology Center, Medical College of Georgia at Augusta University
| | - Daisy Harwood
- Vascular Biology Center, Medical College of Georgia at Augusta University
| | - Lily Bender
- Vascular Biology Center, Medical College of Georgia at Augusta University
| | - Lenee Shrestha
- Vascular Biology Center, Medical College of Georgia at Augusta University
| | - Michael W. Brands
- Physiology Department, Medical College of Georgia at Augusta University
| | - M. Jane Morwitzer
- Vascular Biology Center, Medical College of Georgia at Augusta University
| | - Simone Kennard
- Vascular Biology Center, Medical College of Georgia at Augusta University
| | - Galina Antonova
- Vascular Biology Center, Medical College of Georgia at Augusta University
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Dong OM. Excessive dietary sodium intake and elevated blood pressure: a review of current prevention and management strategies and the emerging role of pharmaconutrigenetics. BMJ Nutr Prev Health 2018; 1:7-16. [PMID: 33235949 PMCID: PMC7678480 DOI: 10.1136/bmjnph-2018-000004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Olivia M Dong
- Center for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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44
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Mancia G, Oparil S, Whelton PK, McKee M, Dominiczak A, Luft FC, AlHabib K, Lanas F, Damasceno A, Prabhakaran D, La Torre G, Weber M, O'Donnell M, Smith SC, Narula J. The technical report on sodium intake and cardiovascular disease in low- and middle-income countries by the joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association. Eur Heart J 2018; 38:712-719. [PMID: 28110297 DOI: 10.1093/eurheartj/ehw549] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/25/2016] [Indexed: 01/04/2023] Open
Abstract
Ingestion of sodium is essential to health, but excess sodium intake is a risk factor for hypertension and cardiovascular disease. Defining an optimal range of sodium intake in populations has been challenging and controversial. Clinical trials evaluating the effect of sodium reduction on blood pressure have shown blood pressure lowering effects down to sodium intake of less than 1.5 g/day. Findings from these blood pressure trials form the basis for current guideline recommendations to reduce sodium intake to less than 2.3 g/day. However, these clinical trials employed interventions that are not feasible for population-wide implementation (i.e. feeding studies or intensive behavioural interventions), particularly in low and middle-income countries. Prospective cohort studies have identified the optimal range of sodium intake to reside in the moderate range (3-5 g/day), where the risk of cardiovascular disease and death is lowest. Therefore, there is consistent evidence from clinical trials and observational studies to support reducing sodium intake to less than 5 g/day in populations, but inconsistent evidence for further reductions below a moderate intake range (3-5 g/day). Unfortunately, there are no large randomized controlled trials comparing low sodium intake (< 3 g/day) to moderate sodium intake (3-5 g/day) in general populations to determine the net clinical effects of low sodium intake. Until such trials are completed, it is likely that controversy about optimal sodium intake range will continue. This working group calls for the completion of large definitive clinical trials to clarify the range of sodium intake for optimal cardiovascular health within the moderate to low intake range. We support interventions to reduce sodium intake in populations who consume high sodium intake (> 5 g/day), which should be embedded within an overall healthy dietary pattern.
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Affiliation(s)
- Giuseppe Mancia
- University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milano, Italy
| | - Suzanne Oparil
- University of Alabama at Birmingham, 703 19th St. South, ZRB 1034, Birmingham, Alabama 35294-0007
| | - Paul K Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, Louisiana 70112, USA
| | - Martin McKee
- ECOHOST, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Anna Dominiczak
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Wolfson Medical School Building, University Avenue, Glasgow G12 8QQ, UK
| | - Friedrich C Luft
- Experimental and Clinical Research Center LindenbergerWeg 80, 131225 Berlin, Germany
| | - Khalid AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, PO Box 7805, Riyadh 11472, Saudi Arabia
| | - Fernando Lanas
- Medcina Interna, Universidad de la Frontera, M Montt 112, Temuco 4780000, Chile
| | - Albertino Damasceno
- Department of Medicine, Faculty of Medicine, Eduardo Mondlane University, Agostinho Neto Ave. 679, Maputo, 1111 Mozambique
| | - Dorairaj Prabhakaran
- Research & Policy, Plot No. 47, Sector 44, Near HUDA City Metro Station, Gurgaon, Haryana 122002, India
| | - Giuseppe La Torre
- Department of Medicine, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Michael Weber
- Division of Cardiovascular Medicine, The State University of New York, Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, New York 11203, USA
| | - Martin O'Donnell
- HRB-Clinical Research Facility Galway, NUI Galway, Newcastle Rd., Galway, Ireland
| | - Sidney C Smith
- Department of Medicine, The University of North Carolina in Chapel Hill, 125 MacNider Hall, Campus Box #7005, Chapel Hill NC 27599-7005, USA
| | - Jagat Narula
- St. Luke's/Roosevelt Hospital of Mount Sinai, 1111 Amsterdam Avenue, New York, NY 10025, USA
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Gildea JJ, Xu P, Kemp BA, Carlson JM, Tran HT, Bigler Wang D, Langouët-Astrié CJ, McGrath HE, Carey RM, Jose PA, Felder RA. Sodium bicarbonate cotransporter NBCe2 gene variants increase sodium and bicarbonate transport in human renal proximal tubule cells. PLoS One 2018; 13:e0189464. [PMID: 29642240 PMCID: PMC5895442 DOI: 10.1371/journal.pone.0189464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/28/2017] [Indexed: 01/11/2023] Open
Abstract
RATIONALE Salt sensitivity of blood pressure affects >30% of the hypertensive and >15% of the normotensive population. Variants of the electrogenic sodium bicarbonate cotransporter NBCe2 gene, SLC4A5, are associated with increased blood pressure in several ethnic groups. SLC4A5 variants are also highly associated with salt sensitivity, independent of hypertension. However, little is known about how NBCe2 contributes to salt sensitivity, although NBCe2 regulates renal tubular sodium bicarbonate transport. We hypothesized that SLC4A5 rs10177833 and rs7571842 increase NBCe2 expression and human renal proximal tubule cell (hRPTC) sodium transport and may be a cause of salt sensitivity of blood pressure. OBJECTIVE To characterize the hRPTC ion transport of wild-type (WT) and homozygous variants (HV) of SLC4A5. METHODS AND RESULTS The expressions of NBCe2 mRNA and protein were not different between hRPTCs carrying WT or HV SLC4A5 before or after dopaminergic or angiotensin (II and III) stimulation. However, luminal to basolateral sodium transport, NHE3 protein, and Cl-/HCO3- exchanger activity in hRPTCs were higher in HV than WT SLC4A5. Increasing intracellular sodium enhanced the apical location of NBCe2 in HV hRPTCs (4.24±0.35% to 11.06±1.72% (P<0.05, N = 3, 2-way ANOVA, Holm-Sidak test)) as determined by Total Internal Reflection Fluorescence Microscopy (TIRFM). In hRPTCs isolated from kidney tissue, increasing intracellular sodium enhanced bicarbonate-dependent pH recovery rate and increased NBCe2 mRNA and protein expressions to a greater extent in HV than WT SLC4A5 (+38.00±6.23% vs HV normal salt (P<0.01, N = 4, 2-way ANOVA, Holm-Sidak test)). In hRPTCs isolated from freshly voided urine, bicarbonate-dependent pH recovery was also faster in those from salt-sensitive and carriers of HV SLC4A5 than from salt-resistant and carriers of WT SLC4A5. The faster NBCe2-specific bicarbonate-dependent pH recovery rate in HV SCL4A5 was normalized by SLC4A5- but not SLC4A4-shRNA. The binding of purified hepatocyte nuclear factor type 4A (HNF4A) to DNA was increased in hRPTCs carrying HV SLC4A5 rs7571842 but not rs10177833. The faster NBCe2-specific bicarbonate-dependent pH recovery rate in HV SCL4A5 was abolished by HNF4A antagonists. CONCLUSION NBCe2 activity is stimulated by an increase in intracellular sodium and is hyper-responsive in hRPTCs carrying HV SLC4A5 rs7571842 through an aberrant HNF4A-mediated mechanism.
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Affiliation(s)
- John J. Gildea
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
| | - Peng Xu
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
| | - Brandon A. Kemp
- The University of Virginia Department of Medicine, Charlottesville, VA, United States of America
| | - Julia M. Carlson
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
| | - Hanh T. Tran
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
| | - Dora Bigler Wang
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
| | | | - Helen E. McGrath
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
| | - Robert M. Carey
- The University of Virginia Department of Medicine, Charlottesville, VA, United States of America
| | - Pedro A. Jose
- The George Washington University School of Medicine & Health Sciences, Department of Medicine, Division of Renal Disease and Hypertension and Department of Pharmacology and Physiology, Washington, DC, United States of America
| | - Robin A. Felder
- The University of Virginia Department of Pathology, Charlottesville, VA, United States of America
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Salt sensitivity of blood pressure at age 8 years in children born preterm. J Hum Hypertens 2018; 32:367-376. [PMID: 29581556 DOI: 10.1038/s41371-018-0045-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/16/2018] [Accepted: 02/07/2018] [Indexed: 12/24/2022]
Abstract
Preterm birth and low birth weight have been associated with an increased risk of hypertension; postnatal growth and dietary salt intake may contribute to these associations. In adults, the change of blood pressure (BP) in response to modifications in salt intake, i.e., salt sensitivity of BP, has been independently associated with cardiovascular disease. Little is known about salt sensitivity in children. We hypothesize that it may partly explain the association between preterm birth and higher BP in later life. We assessed salt sensitivity of BP at age 8 years in 63 preterm-born children, and explored its association with postnatal growth, sodium intake, and body composition from infancy onwards. BP was measured at baseline and after a 7-day high-salt diet. The difference in mean arterial pressure (MAP) was calculated; salt sensitivity was defined as an increase in MAP of ≥5%. Ten children (16%) showed salt sensitivity of BP, which was associated with neonatal growth restriction as well as with lower fat mass and BMI from infancy onwards. At age 8 years, children classified as salt sensitive had a lower weight-for-age SD-score (-1.5 ± 1.3 vs. -0.6 ± 1.1) and BMI (13.8 ± 1.7 vs. 15.5 ± 1.8 kg/m2) compared to their salt resistant counterparts. Sodium intake was not associated with (salt sensitivity of) BP. Salt sensitivity of BP was demonstrated in preterm-born children at age 8 years and may contribute to the development of cardiovascular disease at later age. Long-term follow-up studies are necessary to assess reproducibility of our findings and to explore clustering with other cardiovascular risk factors.
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Yang Y, Liu X, Liu Y, Fu H, Gao Y, Liu X, Jiang X. The development of salt-sensitive hypertension regulated by PSGL-1 gene in mice. Cell Biosci 2018. [PMID: 29541444 PMCID: PMC5842562 DOI: 10.1186/s13578-018-0218-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background and objective Chronic inflammatory is involved in the development of salt-sensitive hypertension and other cardiovascular diseases. PSGL-1 plays an important role in the inflammatory response. Methods and results In this study, we used PSGL-1−/− and PSGL-1+/+ mice fed with high salt diet to measure the blood pressure, inflammatory response and vascular injury. We found that, in PSGL-1+/+ mice, high salt diet resulted in high blood pressure with the increased expression of serum inflammatory cytokines IL-6, IL-1β and TNFɑ, vascular injury markers MCP-1, ET-1, and VWF, and renal macrophages and T cells infiltration, and endothelium-dependent acetylcholine vasodilation dysfunction. However, the influence was not found in PSGL-1−/− mice. The deficiency of PSGL-1 prevented the increased adhesion of peripheral blood mononuclear cells to endothelial cells by high salt environment. Conclusions Our results indicate that PSGL-1 is involved in the development of salt-sensitive hypertension via vascular inflammation and injury. The high salt induced inflammation may be initiated by leukocytes and endothelial cells adhesion through PSGL-1 binding with P-selectin or/and E-selectin.
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Affiliation(s)
- Yuhui Yang
- Beijing No. 8 High School. 2 Xue Yuan Street, Xicheng District, Beijing, 100032 People's Republic of China
| | - Xue Liu
- 2Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences (CAMS) & Comparative Medicine Centre, Peking Union Medical Collage (PUMC), 5 Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021 People's Republic of China
| | - Yunpeng Liu
- 2Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences (CAMS) & Comparative Medicine Centre, Peking Union Medical Collage (PUMC), 5 Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021 People's Republic of China
| | - Hui Fu
- 2Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences (CAMS) & Comparative Medicine Centre, Peking Union Medical Collage (PUMC), 5 Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021 People's Republic of China
| | - Ying Gao
- Beijing No. 8 High School. 2 Xue Yuan Street, Xicheng District, Beijing, 100032 People's Republic of China
| | - Xing Liu
- 2Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences (CAMS) & Comparative Medicine Centre, Peking Union Medical Collage (PUMC), 5 Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021 People's Republic of China
| | - Xiaoliang Jiang
- 2Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences (CAMS) & Comparative Medicine Centre, Peking Union Medical Collage (PUMC), 5 Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021 People's Republic of China
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Fenwick PH, Jeejeebhoy K, Dhaliwal R, Royall D, Brauer P, Tremblay A, Klein D, Mutch DM. Lifestyle genomics and the metabolic syndrome: A review of genetic variants that influence response to diet and exercise interventions. Crit Rev Food Sci Nutr 2018; 59:2028-2039. [PMID: 29400991 DOI: 10.1080/10408398.2018.1437022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Metabolic syndrome (MetS) comprises a cluster of risk factors that includes central obesity, dyslipidemia, impaired glucose homeostasis and hypertension. Individuals with MetS have elevated risk of type 2 diabetes and cardiovascular disease; thus placing significant burdens on social and healthcare systems. Lifestyle interventions (comprised of diet, exercise or a combination of both) are routinely recommended as the first line of treatment for MetS. Only a proportion of people respond, and it has been assumed that psychological and social aspects primarily account for these differences. However, the etiology of MetS is multifactorial and stems, in part, on a person's genetic make-up. Numerous single nucleotide polymorphisms (SNPs) are associated with the various components of MetS, and several of these SNPs have been shown to modify a person's response to lifestyle interventions. Consequently, genetic variants can influence the extent to which a person responds to changes in diet and/or exercise. The goal of this review is to highlight SNPs reported to influence the magnitude of change in body weight, dyslipidemia, glucose homeostasis and blood pressure during lifestyle interventions aimed at improving MetS components. Knowledge regarding these genetic variants and their ability to modulate a person's response will provide additional context for improving the effectiveness of personalized lifestyle interventions that aim to reduce the risks associated with MetS.
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Affiliation(s)
- Peri H Fenwick
- a Department of Human Health and Nutritional Sciences , University of Guelph , Guelph , Ontario , Canada
| | - Khursheed Jeejeebhoy
- b Emeritus Professor of Medicine and Physician , St. Michael's Hospital , Toronto , Ontario , Canada
| | | | - Dawna Royall
- d Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Paula Brauer
- d Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Angelo Tremblay
- e Department of Kinesiology , Faculty of Medicine, Université Laval , Québec City , Québec , Canada
| | - Doug Klein
- f Department of Family Medicine , University of Alberta , Edmonton , Alberta , Canada
| | - David M Mutch
- a Department of Human Health and Nutritional Sciences , University of Guelph , Guelph , Ontario , Canada
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Kisioglu B, Nergiz-Unal R. The powerful story against cardiovascular diseases: Dietary factors. FOOD REVIEWS INTERNATIONAL 2017. [DOI: 10.1080/87559129.2017.1410172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Betul Kisioglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Reyhan Nergiz-Unal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Ditisheim A, Wuerzner G, Ponte B, Vial Y, Irion O, Burnier M, Boulvain M, Pechère-Bertschi A. Prevalence of Hypertensive Phenotypes After Preeclampsia: A Prospective Cohort Study. Hypertension 2017; 71:103-109. [PMID: 29133363 DOI: 10.1161/hypertensionaha.117.09799] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/16/2017] [Accepted: 09/13/2017] [Indexed: 12/13/2022]
Abstract
Preeclampsia is associated with increased cardiovascular and renal risk. The aim of this prospective cohort study was to characterize the early postpartum blood pressure (BP) profile after preeclampsia. We enrolled 115 women with preeclampsia and 41 women with a normal pregnancy in a prospective cohort study. At 6 to 12 week postpartum, we assessed the prevalence of different hypertensive phenotypes using 24-hour ambulatory BP monitoring (ABPM), as well as the risk of salt sensitivity and the variability of BP derived from ABPM parameters. Among patients with preeclampsia, 57.4% were still hypertensive at the office. Daytime ABP was significantly higher in the preeclampsia group (118.9±15.0/83.2±10.4 mm Hg) than in controls (104.8±7.9/71.6±5.3 mm Hg; P<0.01). Differences between groups were similar for nocturnal BP values. Fifty percent of preeclampsia women remained hypertensive on ABPM in the postpartum, of whom 24.3% were still under antihypertensive treatment; 17.9% displayed a white-coat hypertension and 11.6% had masked hypertension. In controls, 2.8% had white-coat hypertension; none had masked hypertension or needed hypertensive treatment. The prevalence of nondippers was similar 59.8% in the preeclampsia group versus 51.4% in controls. High-risk class of salt sensitivity of BP was increased in preeclampsia women (48.6%) compared with controls (17.1%); P<0.01. In conclusion, ABPM 6 to 12 weeks after delivery reveals a high rate of sustained ambulatory, nocturnal, and masked hypertension after preeclampsia. This finding may help identify women who should be included in a postpartum cardiovascular risk management program. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01095939.
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Affiliation(s)
- Agnès Ditisheim
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Grégoire Wuerzner
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Belen Ponte
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Yvan Vial
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Olivier Irion
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Michel Burnier
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Michel Boulvain
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland
| | - Antoinette Pechère-Bertschi
- From the Hypertension Centre (A.D., B.P., M. Boulvain, O.I., A.P.-B.), Service of Nephrology (B.P.), Department of Medical Specialties, and Service of Obstetrics (A.D., O.I., M. Boulvain), Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland; and Service of Nephrology and Hypertension, Department of Medicine (G.W., M. Burnier) and Service of Obstetrics (Y.V.), Department of Gynaecology and Obstetrics, Lausanne University Hospital, Switzerland.
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