A high NaCl diet significantly increased the prevalence of a non-dipper blood pressure pattern in salt-sensitive compared to salt-resistant hypertensive patients (57% vs 26%; OR 3.82; P=0.02).
Does a high NaCl diet attenuate the nocturnal decline in blood pressure in salt-sensitive patients with essential hypertension?
High dietary sodium intake blunts the normal nocturnal decline in blood pressure specifically in salt-sensitive patients with essential hypertension, increasing their likelihood of exhibiting a non-dipper blood pressure pattern.
Effect estimate: OR 3.82
Absolute Event Rate: 57% vs 26%
p-value: p=.02
We investigated the effect of NaCl on the circadian blood pressure rhythm in patients with essential hypertension classified according to the presence or absence of salt sensitivity. We obtained 24-hour noninvasive ambulatory blood pressure measurements in 64 Japanese patients with mild to moderate essential hypertension who ate a low NaCl diet (50 mmol/d) for 1 week, followed by a high NaCl diet (340 mmol/d) for 1 week. Twenty-six patients whose mean blood pressure was increased more than 10% by NaCl loading were classified as salt sensitive. The remaining 38 patients were classified as salt resistant. The nocturnal decline in mean blood pressure was significantly smaller in salt-sensitive patients (8.3+/-1.0%) than in salt-resistant patients (11.5+/-0.9%) (P<.05) during a high NaCl diet but was similar in both groups during a low NaCl diet. There was no significant difference in the prevalence of the non-dipper pattern between groups on a low NaCl diet, but the prevalence of the non-dipper pattern was significantly higher in salt-sensitive patients than in salt-resistant patients on a high NaCl diet (0.57 versus 0.26, chi2=6.4; P=.02; odds ratio, 3.82). These findings suggest that the NaCl loading blunted the nocturnal decline in blood pressure in salt-sensitive patients but not in salt-resistant patients.
Higashi et al. (Fri,) conducted a other in mild to moderate essential hypertension (n=64). High NaCl diet vs. Low NaCl diet (50 mmol/d) was evaluated on Prevalence of the non-dipper blood pressure pattern in salt-sensitive vs salt-resistant patients on a high NaCl diet (OR 3.82, p=.02). A high NaCl diet significantly increased the prevalence of a non-dipper blood pressure pattern in salt-sensitive compared to salt-resistant hypertensive patients (57% vs 26%; OR 3.82; P=0.02).