Key result
Sodium loading in older hypertensives with the TC+CC eNOS genotype resulted in a significantly greater increase in mean arterial blood pressure (P=0.018) and decline in renal plasma flow (P=0.007) compared to those with the TT genotype.
Why the study?
Does the T-786C eNOS gene polymorphism influence renal hemodynamic and blood pressure responses to dietary sodium loading in older hypertensive patients?
RCT (n=28)
Double-blind
Randomized
No
Does the T-786C eNOS gene polymorphism influence renal hemodynamic and blood pressure responses to dietary sodium loading in older hypertensive patients?
p-value: p=0.018
The T-786C eNOS gene polymorphism is associated with increased blood pressure and altered renal hemodynamics in response to sodium loading in older hypertensive patients.
eNOS genotyping may refine sodium sensitivity assessment in older hypertension; leaves open clinical utility pending interventional studies.
The purpose of the present study was to examine the role of the T-786C endothelial nitric oxide synthase (eNOS) gene polymorphism on changes in renal hemodynamics and blood pressure due to Na(+) loading. Twenty-eight older (63+/-1 years), moderately obese (39+/-2 % fat) hypertensives had their glomerular filtration rate (GFR), renal plasma flow (RPF), blood pressure (BP) and plasma nitric oxide (NO(x)) levels determined after eight days of low (20 mEq) and high (200 mEq) Na(+) diets. The two Na(+) diets were separated by a 1-week washout period. Subjects were genotyped for the eNOS-786 site and were grouped on whether they were homozygous or heterozygous for the C allele (TC+CC, n=13) or only homozygous for the T allele (TT, n=15). The TC+CC genotype group had a significantly greater increase in diastolic (P=0.021) and mean arterial (P=0.018) BP and a significant decline in both RPF (P=0.007) and GFR (P=0.029) compared to the TT genotype group with Na(+) loading. Furthermore, Na(+) loading resulted in a significant (P=0.036) increase in plasma NO(x) in the TT, but not in the TC+CC genotype group as well as a trend (P=0.051) for an increase in urine NO(x) in TC+CC, but not in the TT genotype group. The increase in BP during Na(+) loading in older hypertensives was associated with the eNOS genotype and may be related to changes in renal hemodynamics due to changes in NO metabolism.
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Dengel et al. (2007) conducted an RCT in Mild hypertension (n=28). High dietary sodium vs. Low dietary sodium (20 mmol/l/day) was evaluated on Interaction of eNOS gene polymorphism (TC+CC vs TT) and dietary sodium on mean arterial blood pressure (p=0.018). Sodium loading in older hypertensives with the TC+CC eNOS genotype resulted in a significantly greater increase in mean arterial blood pressure (P=0.018) and decline in renal plasma flow (P=0.007) compared to those with the TT genotype.
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