Assessment of salt sensitivity in essential hypertension by 24-h ambulatory blood pressure monitoring

Author(s): Lluch, M. D., Coca, A., Aguilera, M. T., Sanchez, M., Sierra, C., Urbanomarquez, A.

Journal/Book: Amer J Hypertens. 1995; 8: 655 Avenue of the Americas, New York, NY 10010. Elsevier Science Publ Co Inc. 970-977.

Abstract: We used ambulatory blood pressure monitoring (ABPM) in the assessment of salt sensitivity in 40 essential hypertensive patients, comparing 24-h mean blood pressure during 7 days of low salt (20 mmol NaCl/day) and high salt (260 mmol NaCl/day) intake, Salt sensitivity was diagnosed in 18 essential hypertensive patients (45%), each of them showing a significant increase in mean blood pressure (P <.05) from low to high salt diet. Salt-sensitive patients exhibited a high-salt-dependent increase in all blood pressure parameters including 24-h systolic, mean, diastole blood pressure, blood pressure load, area under the curve, and awake and asleep blood pressure values. These patients exhibited a nondipper profile on both low-salt and high-salt diets. Salt-resistant patients (55%) showed a decrease in awake, and an increase in asleep blood pressure values after high salt intake, thus tending to flatten the circadian blood pressure profile. We conclude that ABPM is a useful method to assess salt sensitivity. In salt-resistant patients high salt intake induces a significant increase in asleep blood pressure with no significant changes in 24-h blood pressure, promoting a flattened blood pressure curve and tending to transform a dipper into a nondipper profile, which could have important implications in end-organ damage.

Note: Article A Delasierra, Univ Barcelona, Hosp Clin Barcelona, Dept Internal Med, Hypertens Unit, Villarroel 170, E-08036 Barcelona, Spain

Keyword(s): ambulatory blood pressure monitoring; salt sensitivity; blood pressure; circadian rhythm

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