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Blood pressure changes after high- and low-salt diets: are intermittent arm measures and beat-by-beat finger measures equivalent?

Journal of Human Hypertension volume 29, pages 430–435 (2015)Cite this article

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Abstract

The assessment of sodium sensitivity requires to measure the difference in mean arterial pressure (MAP) at the end of sodium-loading (SLoad) and sodium-depletion (SDepl) maneuvers with an arm-cuff manometer. Aim of this study is to evaluate whether MAP measuring devices based on the volume-clamp method at the finger can also be used for assessing sodium sensitivity. Sixty-eight normotensive volunteers underwent SLoad and SDepl diets in random order. MAP was simultaneously measured at the end of each diet with arm (Spacelabs 90207) and finger (Portapres model-2) cuff devices. The sodium sensitivity was assessed as the difference in MAP at the end of SLoad and SDepl diets (ΔMAP), and as salt-sensitivity index (SSI; SSI=ΔMAP divided by the difference in urinary-sodium-excretion rate at the end of the diets). Discrepancies between finger and arm-cuff devices in ΔMAP or SSI were evaluated by Bland and Altman analysis. Even if discrepancies between devices had null-fixed bias, results showed a significant proportional bias and large limits of agreement (between −25 and 25 mm Hg for ΔMAP, between −196 and 180 mm Hg mol−1 per day for SSI). The SSI distribution over the group was larger, flatter and less symmetric if derived from finger-cuff rather than arm-cuff devices, and this influenced substantially the identification of salt-sensitive individuals. Therefore, the response of MAP to SLoad/SDepl diets and consequently the assessment of the salt-sensitivity condition depends importantly on the measurement site, and brachial measures should be preferred for consistency with literature and normative data.

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Authors and Affiliations

  1. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy

    P Castiglioni & M Di Rienzo

  2. Department of Cardiology, Istituto Auxologico Italiano, Milan, Italy

    G Parati

  3. Department of Health Sciences, University of Milano-Bicocca, Milan, Italy

    G Parati

  4. Fondazione Don Carlo Gnocchi, Parma, Italy

    V Brambilla, L Brambilla, M Gualerzi & D Lazzeroni

  5. Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy

    P Coruzzi

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  1. P Castiglioni
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  2. G Parati
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  3. M Di Rienzo
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  4. V Brambilla
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  5. L Brambilla
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  6. M Gualerzi
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  7. D Lazzeroni
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  8. P Coruzzi
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Correspondence to G Parati.

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Castiglioni, P., Parati, G., Di Rienzo, M. et al. Blood pressure changes after high- and low-salt diets: are intermittent arm measures and beat-by-beat finger measures equivalent?. J Hum Hypertens 29, 430–435 (2015). https://doi.org/10.1038/jhh.2014.110

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