Dietary Treatment of Hypertension. Ii. Sodium Depletion as Related to the Therapeutic Effect 1

Dole, Vincent P.; Dahl, Lewis K.; Cotzias, George C.; Dziewiatkowski, Dominic D.; Harris, Cecilia

doi:10.1172/jci102476

Cited by 95 publications

(26 citation statements)

References 3 publications

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“…These dietary effects are also present in hypertensive man (15,16). It is possible that these diets lower blood pressure by reducing the elevated sodium or potassium in the arteries of hypertensives to a more normal level.…”

Section: Discussionmentioning

confidence: 99%

Artery Wall Electrolytes in Renal and Dca hypertension1

Tobian¹,

Binion²

1954

J. Clin. Invest.

138

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PART IRenal Hypertension In an earlier study it was found that the renal artery of necropsied hypertensive subjects contained abnormally large amounts of sodium and water (1). The present study deals with the electrolyte composition of the aorta in rats with renal hypertension. After these aortas have been stripped of adventitia, at least two-fifths of the total area in tissue sections is occupied by smooth muscle cells. The remainder is largely connective tissue. The rat aorta thus provides for analysis a tissue rich in arterial smooth muscle. Moreover, the smooth muscle cells in the aorta are continuous with and have many of the pharmacological reactions of similar cells in the smaller arteries and arterioles (2). It seemed likely that any chemical alteration occurring in the aorta would give a clue to similar changes in the smooth muscle of arterioles. Technical difficulties have so far prevented us from analyzing the electrolyte content in the walls of arterioles. METHODSHypertension was produced by compressing one kidney of 250 gm. male rats with a figure-of-eight ligature and removing the other kidney six days later. All the rats were fed rat chow 3 (.3 per cent sodium and 1.2 per cent potassium) and water ad lib. Eight weeks or longer after the second operation, blood pressure was determined and the rats were sacrificed for tissue analysis.The aortas were dissected, stripped of adventitia, blotted free of blood, and placed in weighing bottles. In one series of rats, tissues were dried, defatted, and extracted with 0.75N HNO, according to the method of Lowry and Hastings (3). Sodium and potassium concentrations 1 This investigation was supported by a grant-in-aid from The American Heart Association.2This work was done during the tenure of an Established Investigatorship of the American Heart Association. 3 Obtained from Uncle Johnny Mills, Houston, Texas.in the extract were determined with a Weichselbaum flame photometer. Chloride was determined by the potentiometric method of Kolthoff and Kuroda (4). In using this method, standard chloride solutions were used to bracket the unknown solutions. In another series of rats the tissues were dried and defatted as above, and extracted with 10 per cent trichloroacetic acid. Magnesium concentration was determined in this extract using the titan yellow method of Kunkel, Pearson, and Schweigert (5). Polyvinyl alcohol (Elvanol 51-05) was used to prevent precipitation of the MgOH-titan yellow complex.Sera were analyzed for water, sodium, and potassium by the same methods. Blood urea was determined by a standard urease-nesslerization method.Mean blood pressures were determined under ether anesthesia by direct puncture of the abdominal aorta below the level of the renal arteries. It was found that the depth of ether anesthesia could be varied considerably without changing the mean blood pressure. When the breathing of the rat indicated the proper plane of anesthesia, the blood pressure was read on the mercury manometer. This method gives very consistent results on normal...

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Section: Discussionmentioning

confidence: 99%

Artery Wall Electrolytes in Renal and Dca hypertension1

Tobian¹,

Binion²

1954

J. Clin. Invest.

138

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“…day), and then were returned to the basal diet. As in the previous studies (1,2), the patients were weighed to a precision of 100 gm. each morning after they had voided and before breakfast.…”

Section: Methodsmentioning

confidence: 99%

“…In the subsequent study (2), which was directed mainly to the role of sodium, it was found that extreme changes in the ration of sodium had no important effect on the appetite or weight. Again in this study, the patients lost weight when given the basal diet despite the fact that all but one received a supplement of salt (10 gm.…”

mentioning

confidence: 99%

Dietary Treatment of Hypertension. Iii. The Effect of Protein on Appetite and Weight

Dole¹,

Dahl²,

Schwartz³

et al. 1953

J. Clin. Invest.

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“…In Table III, balance calculations for Na and Cl on this group have been made using stool excretion data from previous similar experiments (1,2). Because of the wide variations possible in intake, balance calculations were not made for K. It will be seen that all of the patients were in approximate Na balance with the exception of patient Os, and the three-day period in patient Di, whose long-term balance was positive as indicated by urinary excretion and plasma Na.…”

Section: Balance Datamentioning

confidence: 99%

“…Na per day, combined urine and stool losses average 1 to 5 mEq. Na per day (1,2). Therefore, over an extended period the loss of electrolyte through the skin might assume importance.…”

mentioning

confidence: 99%

Metabolic Effects of Marked Sodium Restriction in Hypertensive Patients. Skin Electrolyte Losses 1

Dahl¹,

Stall²,

Cotzias³

1955

J. Clin. Invest.

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The increasing use of prolonged Na restriction in the treatment of cardiovascular diseases in particular, makes study of long-term Na balance pertinent. With diets which contain 2 to 7 mEq. Na per day, combined urine and stool losses average 1 to 5 mEq. Na per day (1, 2). Therefore, over an extended period the loss of electrolyte through the skin might assume importance. Only two earlier studies were found relative to electrolyte losses of the entire skin, both after shortterm Na restriction, namely 3 (3) and 14 (4) days.The data from Benedict's classical study (5) of an individual who fasted for one month have relevance to any work on the physiological response to dietary restriction, but the metabolic effects of starvation are not directly applicable to those effected by limitation of only two dietary components-namely sodium and chloride.For almost seven years the authors of the present paper have been using a diet which contains about 6 mEq. Na per day in the study and treatment of patients with essential hypertension. On such a regimen combined urine and stool losses average 2 to 5 mEq. Na per day, and since no evidence of hyponatremia had been found in the absence of serious renal disease, it was reasonable to suppose that the patients were in Na balance. The current study was undertaken to quantitate the actual skin losses of several electrolytes on seven subjects who had been on the low Na regimen for one to five months, during two collection periods of 7 and 3 days. Although interest was centered primarily on Na, Cl and K were measured as well. MATERIALThe seven white adult subjects had been admitted to the metabolic wards of the Brookhaven National Laboratory Hospital for studies relative to the hypertension 1 This research was sponsored by the Atomic EnergyCommission.research program. The pertinent clinical and laboratory data on these patients are summarized in Table I. It will be seen that five of the patients, all females, had classical uncomplicated benign hypertension. In two (Di, Jo), the blood pressure had attained near-normal levels by the end of the six-weec control period and be-

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Dietary Treatment of Hypertension. Ii. Sodium Depletion as Related to the Therapeutic Effect 1

Cited by 95 publications

References 3 publications

Artery Wall Electrolytes in Renal and Dca hypertension1

Artery Wall Electrolytes in Renal and Dca hypertension1

Dietary Treatment of Hypertension. Iii. The Effect of Protein on Appetite and Weight

Metabolic Effects of Marked Sodium Restriction in Hypertensive Patients. Skin Electrolyte Losses 1

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