Detecting Sodium-Sensitivity in Hypertensive Patients

Castiglioni, Paolo; Parati, Gianfranco; Brambilla, Lorenzo; Brambilla, Valerio; Gualerzi, Massimo; Rienzo, Marco Di; Coruzzi, Paolo

doi:10.1161/hypertensionaha.110.158972

Cited by 46 publications

(28 citation statements)

References 33 publications

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“…We considered recordings previously collected in two studies aimed at evaluating the influence of sodium sensitivity on the cardiovascular control in normotensive [24] and hypertensive [25] healthy subjects. The original dataset in normotensive subjects consisted of recordings in 26 males and 45 females [24].…”

Section: Subjects and Experimental Protocolmentioning

confidence: 99%

Multifractal‐Multiscale Analysis of Cardiovascular Signals: A DFA‐Based Characterization of Blood Pressure and Heart‐Rate Complexity by Gender

et al. 2018

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Detrended Fluctuation Analysis (DFA) is a popular method for assessing the fractal characteristics of biosignals, recently adapted for evaluating the heart-rate multifractal and/or multiscale characteristics. However, the existing methods do not consider the beat-by-beat sampling of heart rate and have relatively low scale resolutions and were not applied to cardiovascular signals other than heart rate. Therefore, aim of this work is to present a DFA-based method for joint multifractal/multiscale analysis designed to address the above critical points and to provide the first description of the multifractal/multiscale structure of interbeat intervals (IBI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) in male and female volunteers separately. The method optimizes data splitting in blocks to reduce the DFA estimation variance and to evaluate scale coefficients with Taylor's expansion formulas and maps the scales from beat domains to temporal domains. Applied to cardiovascular signals recorded in 42 female and 42 male volunteers, it showed that scale coefficients and degree of multifractality depend on the temporal scale, with marked differences between IBI, SBP, and DBP and with significant sex differences. Results may be interpreted considering the distinct physiological mechanisms regulating heart-rate and blood-pressure dynamics and the different autonomic profile of males and females.

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Section: Subjects and Experimental Protocolmentioning

confidence: 99%

Multifractal‐Multiscale Analysis of Cardiovascular Signals: A DFA‐Based Characterization of Blood Pressure and Heart‐Rate Complexity by Gender

et al. 2018

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“…8,11,22 As published by Castiglioni 23 and Bursztyn, 15 we also evaluated the salt sensitivity on a continuous basis through the use of sodium sensitivity index. The sodium sensitivity index was calculated as the ratio between Δmean arterial pressure (MAP, mm Hg) and the difference between urinary sodium excretion rates (ΔU Na V, mmol/d) on a LS and HS diets, expressed by the formula sodium sensitivity index=ΔMAP/ΔU Na V×1000 (mm Hg/mol per day).…”

Section: Assessment Of Salt Sensitivitymentioning

confidence: 99%

Increased Salt Sensitivity of Ambulatory Blood Pressure in Women With a History of Severe Preeclampsia

Martillotti

Ditisheim²,

Burnier³

et al. 2013

Hypertension

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C ardiovascular diseases are the leading cause of death in women, and hypertension is one of the most important risk factor for their development.1 Coronary heart disease mortality is higher in women compared with men, 2 and heart disease death rates now seem to be increasing in women 3 as does the prevalence of hypertension. 4 Case-control and cohort studies consistently report that preeclampsia, a pregnancy-specific disorder, is predictive of future cardiovascular, cerebrovascular, and end-stage renal diseases. 5,6 Women with early onset or severe preeclampsia and preterm delivery are at particularly high risk of cardiovascular disease later in life, including during the premenopausal period.7 A history of preeclampsia should, therefore, be considered when evaluating the risk of cardiovascular disease in women.It is still uncertain whether the association between preeclampsia and cardiovascular disease is explained by adverse effects of preeclampsia itself on target organs or by underlying risk factors that predispose women to both preeclampsia and later cardiovascular and renal diseases. Blood pressure (BP) response to variations in salt intake, known as salt sensitivity, is considered as an independent marker for increased cardiovascular risk. [8][9][10] Salt sensitivity is traditionally defined as an increase in office BP of 5% to 10% or an increase in mean ambulatory BP (ABP) of ≥4 mm Hg with an increase in sodium intake.11 Several factors contribute to the development of salt sensitivity in humans, including aging and changes in renal function, and also hormonal and genetic factors. [12][13][14] The profile of sex hormones has also been shown to affect the salt sensitivity of BP. 15,16 In previous studies, we have shown that women are salt resistant before menopause or when receiving oral contraceptives, 17 but they become salt sensitive after menopause. 18 That observation might be explained by the aging effect but also by the change in hormonal profile as salt sensitivity also develops in younger women with surgical menopause. 19 In the present study, we hypothesized that part of the elevated risk of cardiovascular disease in women with a history of severe preeclampsia may be related to salt sensitivity of BP. To this purpose, we assessed the salt sensitivity of BP in women with a history of severe or early onset preeclampsia Abstract-Cardiovascular diseases are the principal cause of death in women in developed countries and are importantly promoted by hypertension. The salt sensitivity of blood pressure (BP) is considered as an important cardiovascular risk factor at any BP level. Preeclampsia is a hypertensive disorder of pregnancy that arises as a risk factor for cardiovascular diseases. This study measured the salt sensitivity of BP in women with a severe preeclampsia compared with women with no pregnancy hypertensive complications. Forty premenopausal women were recruited 10 years after delivery in a case-control study. Salt sensitivity was defined as an increase of >4 mm Hg in 24-hour ambulatory ...

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“…In this issue of Hypertension, Castiglioni et al 7 propose that a single ABPM session on usual diet can be used to predict a patient's salt sensitivity. At first, this seems counterintuitive, because salt sensitivity is traditionally defined by repeated blood pressure measurements at low versus high sodium states.…”

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confidence: 99%

“…At first, this seems counterintuitive, because salt sensitivity is traditionally defined by repeated blood pressure measurements at low versus high sodium states. It is the practical complexity of such protocols at the clinical setting that motivated Castiglioni et al 7 to search for surrogates of salt sensitivity within tracings of ABPM performed without controlling sodium diet. The richness of data embedded in ABPM seems to have provided them with candidates worthy of further study: the vast evidence linking nondipping of blood pressure during sleep, 3 as well as their own previous observation on higher heart rate during the 24 hours of monitoring, led them to successfully combine both to indentify the majority, though not all, salt-sensitive patients based on "traditional" change from high-to low-salt diet (Figure).…”

mentioning

confidence: 99%