Key result
Combining sodium restriction with RAS blockade is required to regress cardiac hypertrophy.
Sodium intake and the renin-angiotensin system interact significantly at multiple levels, highlighting that while sodium restriction is necessary for RAS blockers to regress cardiac hypertrophy, excessive RAS blockade combined with low sodium can be fatal in rat models.
Combined sodium restriction plus RAS blockade may regress hypertrophy in rat models; leaves open translation to human cardiac remodeling and requires clinical trials.
Increased sodium intake causes decreased formation of angiotensin (Ang) II and increased AngII causes increased Na+ retention. 2. Increased sodium intake and increased AngII causes cardiac hypertrophy, but decreased sodium intake regresses cardiac hypertrophy despite high AngII levels. Likewise, decreased Na+ and blockers of the renin-angiotensin system (RAS) in neonatal rats have similar effects on subsequent blood pressure development. 3. Cardiac hypertrophy due to renal hypertension does not regress when the RAS is blocked and rats are on a high salt intake. Likewise, sodium restriction alone does not cause regression; combination of reduced NaCl intake and RAS blockade is required. 4. High doses of perindopril and losartan in combination cause a syndrome in rats on 0.2% NaCl that leads to profound hypotension, polyuria, renal impairment and involution of the heart and death. This is reversed or prevented by a high (4%) NaCl intake, which also prevents the plasma angiotensinogen depletion that occurs with combined blockade on 0.2% NaCl intake. 5. Intake of NaCl and AngII interact at many levels. It is postulated that there is an important interaction at the cellular level that can explain the above events.
No takes yet. Share an insight, caveat, or question.
Trefor Morgan (2001) conducted a review in Cardiac hypertrophy and hypertension. Sodium intake and renin-angiotensin system blockade was evaluated. Sodium intake and angiotensin II interact at multiple levels, demonstrating that sodium restriction combined with renin-angiotensin system blockade is required to regress cardiac hypertrophy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: