Proposition of a Feasible Protocol to Evaluate Salt Sensitivity in a Population-Based Setting

• Published in: Hypertension Research Vol. 25; no. 6; pp. 801 - 809
• Main Authors: KATO, Norihiro, KANDA, Tomo, SAGARA, Miki, BOS, Angelo, MORIGUCHI, Emilio H., MORIGUCHI, Yukio, YAMORI, Yukio
• Format: Journal Article
• Language: English
• Published: England The Japanese Society of Hypertension 2002
• Subjects: Antihypertensive Agents - pharmacology; Atrial Natriuretic Factor - blood; atrial natriuretic peptide; Blood Pressure - drug effects; Diet; Feasibility Studies; Female; Humans; Hydrochlorothiazide - pharmacology; hypertension; Hypertension - chemically induced; Male; Methods; Middle Aged; Norepinephrine - blood; plasma renin activity; Predictive Value of Tests; Renin - blood; salt sensitivity; Sodium Chloride - adverse effects
• ISSN: 0916-9636; 1348-4214
• DOI: 10.1291/hypres.25.801

Although a variety of techniques have been devised to assess salt sensitivity, most have proven cumbersome from a methodological perspective. We therefore attempted to develop a 2-week method by which participants could be tested in an outpatient setting without requirement of a strict dietary regimen. In this method, subjects take 140 mEq of an NaCl supplement per day for 1 week and 25 mg of hydrochlorothiazide daily for another week while maintaining their customary diet. In our first trial, 8 healthy volunteers submitted to this method, as well as to a widely-used rapid volume expansion and contraction protocol. Blood pressure measurements, blood sampling and 24-h urine collection were performed before, in the middle of, and after each intervention. There was a fair correlation (r =0.69) between the two protocols with respect to the changes in mean blood pressure (ΔMBP), a measure of salt sensitivity. In our second trial, we tested the method on 82 Japanese subjects who had never been treated with antihypertensive drugs. ΔMBP was significantly correlated with plasma renin activity (PRA) during salt loading (r =0.52, p <0.0001) and with the changes in atrial natriuretic peptide (ΔANP) (r =-0.34, p =0.0018). When total subjects were divided into two subgroups by age, a similar tendency of correlation was observed. Age, PRA during salt loading, ΔANP, and Δnorepinephrine were proven to be significant predictors of salt sensitivity and accounted for 46% of the ΔMBP variances. Based on these results, the dietary method presented here seems to be applicable for a population-based survey. Our preliminary data also suggest that PRA and ANP would be of predictive value in the salt sensitivity test. (Hypertens Res 2002; 25: 801-809)