Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Blood pressure and arterial stiffness in patients with high sodium intake in relation to sodium handling and left ventricular diastolic dysfunction status

Journal of Human Hypertension volume 29, pages 583–591 (2015)Cite this article

Subjects

Abstract

In a population with high sodium consumption, we assessed relation between brachial and central blood pressures, elastic properties of large arteries, echocardiographic left ventricular diastolic function and sodium reabsorption as fractional urinary lithium excretion in proximal (FELi) and fractional sodium reabsorption in distal tubules assessed using the endogenous lithium clearance. Mean±s.d. age of 131 treated hypertensive patients (66 men and 65 women) was 61.9±7.5 years. We found significant interaction between left ventricular diastolic function and FELi with respect to the values of brachial blood pressure: systolic (SBP), diastolic (DBP) and mean blood pressure (MBP) (all PINT<0.03). In patients with FELi below the median value and impaired left ventricular diastolic function, the values of SBP (149.3 vs 132.5 mm Hg; P=0.005), DBP (85.1 vs 76.1 mm Hg; P=0.001), MBP (106.5 vs 94.9 mm Hg; P=0.001), central SBP (SBPC) (137.4 vs 122.0 mm Hg; P=0.01), central DBP (DBPC) (84.8 vs 76.0 mm Hg; P=0.003), central MBP (MBPC) (106.9 vs 95.9 mm Hg; P=0.007), aortic pulse wave augmentation (18.0 vs 13.5 mm Hg; P=0.03), pulse wave velocity (14.6 vs 12.5 m s−1; P=0.02) and central aortic pulse wave augmentation index (155.7% vs 140.9%; P=0.01) were significantly higher than in patients with normal left ventricular diastolic function. Such relationships were not observed in the entire group and patients with FELi above the median value. In the hypertensive population with high sodium intake, increased sodium reabsorption in proximal tubules may affect blood pressure parameters and arterial wall damage, thus contributing to the development of left ventricular diastolic function impairment.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Et-Taoui K, Schiavi P, Levy B, Plante G . Sodium intake, large artery stiffness, and proteoglycans in the spontaneously hypertensive rat. Hypertension 2001; 38: 1172–1176.

    Article  Google Scholar 

  2. Levy BI, Poitevin P, Safar ME . Effect of indapamide on the mechanical properties of the arterial wall in deoxycorticosterone acetate-salt hypertensive rats. Am J Cardiol 1990; 65: 28–32.

    Article  Google Scholar 

  3. Avolio AP, Deng FQ, Li WQ, Huang ZD, Xing LF, O'Rourke MF . Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension: comparison between urban and rural communities in China. Circulation 1985; 71: 202–210.

    Article  CAS  Google Scholar 

  4. Redelinghuys M, Norton GR, Scott L, Maseko MJ, Brooksbank R, Majane OH et al. Relationship between urinary salt excretion and pulse pressure and central aortic hemodynamics independent of steady state pressure in the general population. Hypertension 2010; 56: 584–590.

    Article  CAS  Google Scholar 

  5. Burnier M, Phan O, Wang Q . High salt intake: a cause of blood pressure-independent left ventricular hypertrophy? Nephrol Dial Transplant 2007; 22: 2426–2429.

    Article  Google Scholar 

  6. Langenfeld MR, Schobel H, Veelken R, Weihprecht H, Schmieder RE . Impact of dietary sodium intake on left ventricular diastolic filling in early essential hypertension. Eur Heart J 1998; 19: 951–958.

    Article  CAS  Google Scholar 

  7. Burnier M, Biollaz J, Magnin JL, Bidlingmeyer M, Brunner HR . Renal sodium handling in patients with untreated hypertension and white coat hypertension. Hypertension 1994; 3: 496–502.

    Article  Google Scholar 

  8. Strazzullo P, Galletti F, Barba G . Altered renal handling of sodium in human hypertension: short review of the evidence. Hypertension 2003; 41: 1000–1005.

    Article  CAS  Google Scholar 

  9. Weder AB . Red-cell lithium-sodium countertransport and renal lithium clearance in hypertension. N Engl J Med 1986; 314: 198–201.

    Article  CAS  Google Scholar 

  10. Chiolero A, Maillard M, Nussberger J, Brunner HR, Burnier M . Proximal sodium reabsorption: an independent determinant of blood pressure response to salt. Hypertension 2000; 36: 631–637.

    Article  CAS  Google Scholar 

  11. Zou J, Li Y, Yan CH, Wei FF, Zhang L, Wang JG . Blood pressure in relation to interactions between sodium dietary intake and renal handling. Hypertension 2013; 62: 719–725.

    Article  CAS  Google Scholar 

  12. Cappuccio FP, Strazzullo P, Farinaro E, Trevisan M . Uric acid metabolism and tubular sodium handling. Results from a population-based study. JAMA 1993; 270: 354–359.

    Article  CAS  Google Scholar 

  13. Cappuccio FP, Strazzullo P, Siani A, Trevisan M . Increased proximal sodium reabsorption is associated with increased cardiovascular risk in men. J Hypertens 1996; 14: 909–914.

    Article  CAS  Google Scholar 

  14. Seidlerová J, Staessen JA, Maillard M, Nawrot T, Zhang H, Bochud M et al. Association between arterial properties and renal sodium handling in a general population. Hypertension 2006; 48: 609–615.

    Article  Google Scholar 

  15. Jin Y, Kuznetsova T, Maillard M, Richart T, Thijs L, Bochud M et al. Independent relations of left ventricular structure with the 24-hour urinary excretion of sodium and aldosterone. Hypertension 2009; 54: 489–495.

    Article  CAS  Google Scholar 

  16. Cwynar M, Staessen JA, Ticha M, Nawrot T, Citterio L, Kuznetsova T et al. Epistatic interaction between α- and γ-adducin influences peripheral and central pulse pressures in white Europeans. J Hypertens 2005; 23: 961–969.

    Article  CAS  Google Scholar 

  17. Christensen S . Furosemide effect during volume expansion: evidence against lithium transport in the loop. Kidney Int Suppl 1990; 28: S45–S51.

    CAS  PubMed  Google Scholar 

  18. Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007; 28: 2539–2550.

    Article  Google Scholar 

  19. Zhao J, Gao P, Wu S, Zhu D . Determination of trace lithium in human urine by electrothermal atomic absorption spectrometry using nitric acid as a chemical modifier to eliminate the interference of chloride. Anal Sci 2009; 25: 639–643.

    Article  CAS  Google Scholar 

  20. Miller NL, Durr JA, Alfrey AC . Measurement of endogenous lithium levels in serum and urine by electrothermal atomic absorption spectrometry: a method with potential clinical applications. Anal Biochem 1989; 182: 245–249.

    Article  CAS  Google Scholar 

  21. Staessen JA, Kuznetsova T, Zhang H, Maillard M, Bochud M, Hasenkamp S et al. Blood pressure and renal sodium handling in relation to genetic variation in the DRD1 promoter and GRK4. Hypertension 2008; 51: 1643–1650.

    Article  CAS  Google Scholar 

  22. Safar ME, Thuilliez C, Richard V, Benetos A . Pressure-independent contribution of sodium to large artery structure and function in hypertension. Cardiovasc Res 2000; 46: 269–276.

    Article  CAS  Google Scholar 

  23. Partovian C, Benetos A, Pommies JP, Mischler W, Safar ME . Effects of a chronic high-salt diet on large artery structure: role of endogenous bradykinin. Am J Physiol 1998; 274: 1423–1428.

    Google Scholar 

  24. Gu JW, Anand V, Shek EW, Moore MC, Brady AL, Kelly WC et al. Sodium induces hypertrophy of cultured myocardial myoblasts and vascular smooth muscle cells. Hypertension 1998; 31: 1083–1087.

    Article  CAS  Google Scholar 

  25. Hollenberg NK, Meggs LG, Williams GH, Katz J, Garnic JD, Harrington DP . Sodium intake and renal responses to captopril in normal man and in essential hypertension. Kidney Int 1981; 20: 240–245.

    Article  CAS  Google Scholar 

  26. Burnier M, Rutschmann B, Nussberger J, Versaggi J, Shahinfar S, Waeber B et al. Salt-dependent renal effects of an angiotensin II antagonist in healthy subjects. Hypertension 1993; 22: 339–347.

    Article  CAS  Google Scholar 

  27. Noormohamed FH, Fuller GN, Lant AF . Effect of salt balance on the renal and hemodynamic actions of benazepril in normal men. J Clin Pharmacol 1989; 29: 928–937.

    Article  CAS  Google Scholar 

  28. Valvo E, Casagrande P, Bedogna V, Antiga L, Alberti D, Zamboni M et al. Systemic and renal effects of a new angiotensin converting enzyme inhibitor, benazepril, in essential hypertension. J Hypertens 1990; 8: 991–995.

    Article  CAS  Google Scholar 

  29. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213–1225.

    Article  CAS  Google Scholar 

  30. Wiliams B, Lacy PS . CAFÉ and the ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) Investigators. Impact of the heart rate on central arterial pressures and hemodynamics: analysis from the CAFE (Conduit Artery Function Evaluation) study: CAFE-Heart Rate. J Am Coll Cardiol 2009; 54: 705–713.

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported by a Grant provided by the National Science Center, Poland (Grant No. N N402 533239).

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Gerontology, Medical College, Jagiellonian University, Krakow, Poland

    M Cwynar, J Gąsowski, B Wizner, M Dubiel, A Głuszewska, J Królczyk, P Franczuk & T Grodzicki

  2. Department of Nephrology, Hypertension and Internal Diseases, University of Warmia and Mazury, Olsztyn, Poland

    T Stompór

  3. Department of Food Chemistry and Nutrition, Trace Element Research Laboratory, Medical College, Jagiellonian University, Krakow, Poland

    H Bartoń

Authors
  1. M Cwynar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Gąsowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T Stompór
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H Bartoń
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B Wizner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Dubiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A Głuszewska
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J Królczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P Franczuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. T Grodzicki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Cwynar.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on the Journal of Human Hypertension website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cwynar, M., Gąsowski, J., Stompór, T. et al. Blood pressure and arterial stiffness in patients with high sodium intake in relation to sodium handling and left ventricular diastolic dysfunction status. J Hum Hypertens 29, 583–591 (2015). https://doi.org/10.1038/jhh.2015.1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2015.1

This article is cited by

Search

Advanced search

Quick links