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Influence of dietary sodium on the renin–angiotensin–aldosterone system and prevalence of left ventricular hypertrophy by EKG criteria

Journal of Human Hypertension volume 19, pages 133–138 (2005)Cite this article

Abstract

We investigated the interplay of dietary sodium and renin–angiotensin–aldosterone system (RAAS) activity with the prevalence of left ventricular hypertrophy (LVH) in essential hypertension. Electrocardiograms (EKG) were reviewed for the presence of LVH in 160 hypertensive patients. We then compared the rate of LVH to levels of plasma renin activity (PRA) and serum aldosterone under high and low sodium diet conditions. On high sodium diet, serum aldosterone was significantly higher (7.7±0.93 vs 5.7±0.35 ng/dl, P=0.02) in participants with LVH. With low sodium diet and upright posture, PRA was significantly lower in subjects with LVH vs those without (5.6±1.1 vs 7.6±0.56 ng/ml/h, P=0.026). Aldosterone levels on low sodium diet were not different between those with and those without LVH. PRA was then dichotomized at the lowest quartile under low sodium/upright posture conditions to define a ‘low renin’ group. In a multivariate logistic regression containing renin status (low renin vs normal/high renin), aldosterone on a high sodium diet, age, body mass index, gender, race, duration of hypertension, systolic and diastolic blood pressure and salt-sensitivity only low-renin status on a low sodium diet (P=0.019) and serum aldosterone on a high sodium diet (P=0.04) were significant predictors of LVH. Thus, reduced modulation of renin activity in response to sodium restriction and an increased aldosterone on a high sodium diet appear to identify characteristics of hypertensive patients predisposed to abnormal cardiac remodelling.

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Acknowledgements

This research was supported by the following grants: National Institutes of Health Grants HL47651, HL59424, DK63214, Specialized Center of Research in Hypertension from the National Heart, Lung and Blood Institute (HL55000), National Center for Research Resources (General Clinical Research Centers) in Boston (M01 RR 02635) and Salt Lake City (M01 RR 00064). Dr J Williams was in part supported by an NIH training grant (T32 HL 0760917). We gratefully acknowledge the assistance of the dietary, nursing, administrative and laboratory staffs of the three clinical research centres.

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Authors and Affiliations

  1. Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

    J S Williams, G H Williams & P R Conlin

  2. Centre d'Investigation Clinique 92401 Inserm/AP, Departement de Genetique, Hopital European Georges Pompidou, Paris, France

    X Jeunemaitre

  3. Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah

    P N Hopkins

  4. Medical Service, VA Boston Healthcare System, Boston, MA, USA

    P R Conlin

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  1. J S Williams
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Correspondence to J S Williams.

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Williams, J., Williams, G., Jeunemaitre, X. et al. Influence of dietary sodium on the renin–angiotensin–aldosterone system and prevalence of left ventricular hypertrophy by EKG criteria. J Hum Hypertens 19, 133–138 (2005). https://doi.org/10.1038/sj.jhh.1001784

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