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Cited by 83Sodium Intake and HealthBlood Pressure and Hypertension StudiesRenin-Angiotensin System Studies

Renal hemodynamics in essential hypertension. Racial differences in response to changes in dietary sodium.

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Parmer, R J, Stone, R A, Cervenka, J H·1994·Hypertension
DOI 10.1161/01.hyp.24.6.752
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Abstract

Previous studies have suggested striking racial differences in hypertension-related renal disease. To explore potential mechanisms responsible for these differences, we investigated changes in renal hemodynamics in white and black essential hypertensive patients in response to alterations in dietary sodium. Patients were untreated, age-matched, and blood pressure-matched white (n = 59) and black (n = 22) males with essential hypertension. Studies were conducted on an inpatient metabolic ward and included assessment of blood pressure, urinary sodium excretion, glomerular filtration rate, renal plasma flow, and renal blood flow after 5 days each of high and low salt diets. In response to high dietary salt intake, both white and black patients demonstrated significantly higher mean arterial pressure, renal plasma flow, and renal blood flow, and there were no racial differences in the changes in these parameters. However, whites and blacks differed significantly in glomerular filtration rate, with black hypertensive patients showing an increase in glomerular filtration rate (+17.3 +/- 5.3 mL/min per 1.73 m2, F = 7.586, P = .007) and white hypertensive patients showing no change (-0.2 +/- 3.3 mL/min per 1.73 m2) in response to high dietary sodium. These data demonstrate racial differences in the autoregulation of glomerular filtration rate in response to changes in dietary sodium. These differences suggest that glomerular hyperfiltration in response to a high salt diet may be a mechanism contributing to the racial disparity in hypertension-related renal disease.

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  • The proportional (relative risk) reductions in CHD and stroke events were similar in people with and without pre-existing CVD and regardless of blood-pressure levels prior to treatment (down to 110 mm Hg systolic and 70 mm Hg diastolic).

    “In addition, the proportional (relative risk) reductions in CHD and stroke events were similar in people with and without pre-existing CVD and regardless of BP levels prior to treatment (down to 110 mm Hg systolic and 70 mm Hg diastolic).27”

    From Global Sodium Consumption and Death from Cardiovascular Causes (2014) · cites this paper as [27]

  • Beta blockers had a larger effect above and beyond that due to blood-pressure reduction only for preventing recurrent CHD events in patients with a history of CHD, and only limited to the first few years after acute myocardial infarction.

    “Beta blockers had a larger effect above and beyond that due to BP reduction only for preventing recurrent CHD events in patients with a history of CHD, and also only limited to the first few years after acute myocardial infarction.”

    From Global Sodium Consumption and Death from Cardiovascular Causes (2014) · cites this paper as [27]

  • For each major class of anti-hypertensive drugs (thiazides, beta blockers, ACE inhibitors, ARBs, calcium channel blockers), the achieved risk reductions for CHD and stroke in randomized trials were very similar to the predicted benefits based on their blood-pressure-lowering.

    “For each class including thiazides, beta blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers, the achieved risk reductions for CHD and stroke in the trials were very similar to the predicted benefits based on their BP-lowering, based on the observed association between BP and CVD risk in prospective cohorts.14”

    From Global Sodium Consumption and Death from Cardiovascular Causes (2014) · cites this paper as [27]

  • The effects of all major classes of anti-hypertensive drugs principally correspond to their blood-pressure-lowering effects.

    “A meta-analysis of 154 randomized trials of various anti-hypertensive agents and CVD events demonstrated that the effects of all major classes of anti-hypertensive drugs principally correspond to their BP-lowering.27”

    From Global Sodium Consumption and Death from Cardiovascular Causes (2014) · cites this paper as [27]

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Research works printed but not linked: 4

  1. Hall WD. Hypertension in blacks. In: Wollam GL, Hall WD, eds. Hypertension Management. Clinical Practice and Therapeutic Dilemmas. Chicago, 111: Year Book Medical Publishers, Inc; 1988:103-141.
  2. Shulman NB. Renal disease in hypertensive blacks. In: Hall WD, Saunders E, Shulman NB, eds. Hypertension in Blacks: Epide- miology, Pathophysiology and Treatment. Chicago, III: Year Book Medical Publishers, Inc; 1985:106-112.
  3. Preston RA, O'Connor DT, Stone RA. Prazosin and renal hemo- dynamics: arteriolar vasodilation during therapy of essential hyper- tension in man. J Cardiovasc Pharmacol. 1979; 1:277-286.
  4. Brenner BM, Deen WM, Robertson CR. Glomerular filtration. In: Brenner BM, Rector FC, eds. Vie Kidney. Philadelphia, Pa: WB Saunders; 1976:251-271.

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Related

Authors
Parmer, R. J., Stone, R. A., & Cervenka, J. H.
Affiliations
University of California San Diego (US)
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1994-12
Volume
24
Issue
6
Pages
752-757
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/01.hyp.24.6.752
OpenAlex
W2097427106
Cited by
83
References
57
Citations by year
2026: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2017: 2 · 2016: 6 · 2014: 4 · 2013: 1 · 2012: 2
FWCI
3.59
Type
journal article
Language
en
Open access
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • American Heart Association
  • National Institutes of Health (5r01hl050174-02)
  • National Heart, Lung, and Blood Institute (HL50174)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords
essential hypertension, renal hemodynamics, racial differences, dietary sodium, high-salt diet, glomerular filtration rate, renal plasma flow, renal blood flow, glomerular hyperfiltration, Black patients, Caucasian patients
MeSH terms
Adult, Aged, Forecasting, Glomerular Filtration Rate, Hemodynamics, Humans, Hypertension, Male, Middle Aged, Natriuresis, Renal Circulation, Sodium, Dietary, Black People, White People

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