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:

Acute water ingestion increases arterial blood pressure in hypertensive and normotensive subjects

Abstract

In patients with severe autonomic dysfunction, water ingestion elicits an acute pressor response. Hypertension may be associated with changes in cardiovascular autonomic modulation, but there is no information on the acute effects of water ingestion in patients with hypertension. In this study, we compared the effect of acute water ingestion on haemodynamic and autonomic responses of hypertensive and normotensive individuals. Eight patients with mild hypertension were compared to 10 normotensive individuals. After 30 min resting in the supine position all subjects ingested 500 ml of water. At baseline and after water ingestion, venous blood samples for plasma volume determination were collected, and electrocardiographic tracings, finger blood pressure, forearm blood flow and muscle sympathetic nerve activity (MSNA) were obtained. Water ingestion resulted in similar and minor reduction in plasma volume. Systolic and diastolic blood pressure increased in both hypertensive (mean±s.d.: 19/14±6/3 mm Hg) and normotensive subjects (17/14±6/3 mm Hg). There was an increase in forearm vascular resistance and in MSNA. Heart rate was reduced (hypertensive: 5±1 beats/min, normotensive: 5±6 beats/min) and the high-frequency component of heart rate and systolic blood pressure variability was increased. In hypertensive and normotensive individuals, acute water ingestion elicits a pressor response, an effect that is most likely determined by an increased vasoconstrictor sympathetic activity, and is counterbalanced by an increase in blood pressure and heart rate vagal modulation.

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

Access options

Buy this article

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

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Jordan J, Shannon JR, Black BK, Ali Y, Farley M, Costa F et al. The pressor response to water drinking in humans. A sympathetic reflex? Circulation 2000; 101: 504–509.

    Article  CAS  Google Scholar 

  2. Scott EM, Greenwood JP, Gilbey SG, Stoker JB, Mary DA . Water ingestion increases sympathetic vasoconstrictor discharge in normal human subjects. Clin Sci (Lon) 2001; 100: 335–342.

    Article  CAS  Google Scholar 

  3. Cariga P, Mathias CJ . Haemodynamics of the pressor effect of oral water in human sympathetic denervation due to autonomic failure. Clin Sci 2001; 101: 313–319.

    Article  CAS  Google Scholar 

  4. Tank J, Schroeder C, Stoffels M, Diedrich A, Sharma AM, Luft FC et al. Pressor effect of water drinking in tetraplegic patients may be a spinal reflex. Hypertension 2003; 41: 1234–1239.

    Article  CAS  Google Scholar 

  5. Schroeder C, Bush VE, Norcliffe LJ, Luft FC, Tank J, Jordan J et al. Water drinking acutely improves orthostatic tolerance in healthy subjects. Circulation 2002; 106: 2806–2811.

    Article  Google Scholar 

  6. Endo Y, Torii R, Yamazaki F, Sagawa S, Yamauchi K, Tsutsui Y et al. Water drinking causes a biphasic change in blood composition in humans. Pflügers Arch 2001; 442: 362–368.

    Article  CAS  Google Scholar 

  7. Lu CC, Diedrich A, Tung CS, Paranjape SY, Harris PA, Byrne DW et al. Water ingestion as prophylaxis against syncope. Circulation 2003; 108: 2660–2665.

    Article  Google Scholar 

  8. Routledge HC, Chowdhary S, Coote JH, Townend JN . Cardiac vagal response to water ingestion in normal human subjects. Clin Sci (Lond) 2002; 103 (2): 157–162.

    Article  Google Scholar 

  9. Hoffman WE, Phillips MI, Wilson E, Schmid PG . A pressor response associated with drinking in rats. Proc Soc Exp Biol Med 1977; 154: 121–124.

    Article  CAS  Google Scholar 

  10. The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. JAMA 2003; 283: 2560–2572.

  11. Salo TM, Kantola I, Voipio-Pulkki LM, Pelttari L, Viikari JS . The effect of four different antihypertensive medications on cardiovascular regulation in hypertensive sleep apneic patients – assessment by spectral analysis of heart rate and blood pressure variability. Eur J Clin Pharmacol 1989; 55: 191–198.

    Article  Google Scholar 

  12. Patel RB, Patel UR, Rogge MC, Shah VP, Prasad VK, Selen A et al. Bioavailability of hydrochlorothiazide from tablets and suspensions. J Pharm Sci 1984; 73: 359–361.

    Article  CAS  Google Scholar 

  13. Fagius J, Karhuvaara S . Sympathetic activity and blood pressure increases with bladder distension in humans. Hypertension 1989; 14: 511–517.

    Article  CAS  Google Scholar 

  14. Negrão CE, Rondon MUPB, Tinucci T, Alves MJN, Roveda F, Braga AMW et al. Abnormal neurovascular control during exercise is linked to heart failure severity. Am J Physiol Heart Circ Physiol 2001; 280: H1286–H1292.

    Article  Google Scholar 

  15. Negrão CE, Trombetta IC, Batalha LT, Ribeiro MM, Rondon MUPB, Tinucci T et al. Muscle metaboreflex control is diminished in normotensive obese women. Am J Physiol Heart Circ Physiol 2001; 281: H469–H475.

    Article  Google Scholar 

  16. Trombetta IC, Batalha LT, Rondon MU, Laterza MC, Kuniyoshi FH, Gowdak MM et al. Weight loss improves neurovascular and muscle metaboreflex control in obesity. Am J Physiol Heart Circ Physiol 2003; 285: H974–H982.

    Article  CAS  Google Scholar 

  17. Delius W, Hagbarth KE, Hongell A, Wallin BG . Maneuvers affecting sympathetic outflow in human muscle nerves. Acta Physiol Scand 1972; 84: 82–94.

    Article  CAS  Google Scholar 

  18. Vallbo AB, Hagbarth KE, Torebjork HE, Wallin BG . Somatosensory, proprioceptive and sympathetic activity in human peripheral nerves. Physiol Rev 1979; 59: 919–957.

    Article  CAS  Google Scholar 

  19. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysioly. Heart rate variability. Circulation 1996; 93: 1043–1065.

    Article  Google Scholar 

  20. Pagani M, Lucini D . Autonomic dysregulation in essential hypertension: insight from heart rate and arterial pressure variability. Auton Neurosci 2001; 90: 76–82.

    Article  CAS  Google Scholar 

  21. Parati G, Di Rienzo M, Mancia G . Dynamic modulation of baroreflex sensitivity in health and disease. Ann NY Acad Sci 2001; 940: 469–487.

    Article  CAS  Google Scholar 

  22. Dill DB, Costill D . Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 1974; 37: 247–248.

    Article  CAS  Google Scholar 

  23. Brown CM, Barberini L, Dulloo AG, Montani JP . Cardiovascular responses to water drinking: does osmolality play a role? Am J Physiol Regul Integr Comp Physiol 2005; 289: R1687–R1692.

    Article  CAS  Google Scholar 

  24. Raj SR, Biaggioni I, Black BK, Rali A, Jordan J, Taneja I et al. Sodium paradoxically reduces the gastropressor response in patients with orthostatic hypotension. Hypertension 2006; 48: 329–334.

    Article  CAS  Google Scholar 

  25. Rondon MUPB, Laterza MC, Matos LDNJ, Trombetta IC, Braga AMW, Roveda F et al. Abnormal muscle metaboreflex control of sympathetic activity in never-treated hypertensive subjects. Am J Hypertens 2006; 19: 951–957.

    Article  Google Scholar 

  26. Floras JS, Hara K . Sympathoneural and haemodynamic characteristics of young subjects with mild essential hypertension. J Hypertens 1993; 11: 647–655.

    Article  CAS  Google Scholar 

  27. Guzzetti S, Piccaluga E, Casati R, Cerutti S, Lombardi F, Pagani M et al. Sympathetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability. J Hypertens 1988; 6: 711–717.

    Article  CAS  Google Scholar 

  28. Polanczyk CA, Rohde LE, Moraes RS, Ferlin EL, Leite C, Ribeiro JP . Sympathetic nervous system representation in time and frequency domain indices of heart rate variability. Eur J Appl Physiol Occup Physiol 1998; 79: 69–73.

    Article  CAS  Google Scholar 

  29. Taylor JA, Williams TD, Seals DR, Davy KP . Low-frequency arterial pressure fluctuations do not reflect sympathetic outflow: gender and age differences. Am J Physiol Heart Circ Physiol 1998; 274: H1194–H1201.

    Article  CAS  Google Scholar 

  30. Grassi G, Cattaneo BM, Seravalle G, Lanfranchi A, Mancia G . Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 1998; 31 (Part 1): 68–72.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) and Fundação Zerbini.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J P Ribeiro.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Callegaro, C., Moraes, R., Negrão, C. et al. Acute water ingestion increases arterial blood pressure in hypertensive and normotensive subjects. J Hum Hypertens 21, 564–570 (2007). https://doi.org/10.1038/sj.jhh.1002188

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1002188

Keywords

This article is cited by

Search

Quick links