Exaggerated natriuresis in essential hypertension

Baldwin, David S.; Biggs, Albert W.; Goldring, William; Hulet, William H.; Chasis, Herbert

doi:10.1016/0002-9343(58)90342-5

Cited by 148 publications

(55 citation statements)

References 11 publications

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“…However, this pattern has been described in subjects with established hypertension and in response to an acute saline load producing rapid extracellular volume expansion. 33 " 35 More recent investigations have demonstrated a heterogeneity in sodium excretion rates after saline loads in hypertensive patients. 36 Rydstedt et al 37 studied sodium excretion rates after saline infusion in hypertensive individuals grouped by before sodiumloading renin levels.…”

Section: -29mentioning

confidence: 99%

Effect of chronic sodium loading on cardiovascular response in young blacks and whites.

1990

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The effect of long-term oral sodium loading on blood pressure and on stress-induced cardiovascular response was studied in normotensive and marginally hypertensive young adults. The 121 subjects, 18-23 years old, included 38 whites and 83 blacks. Blood pressure and heart rate response to the stress of mental arithmetic was measured before and after 14 days of sodium load, which consisted of 10 g NaCl/day added to the usual diet. A sodium-sensitive response to sodium load occurred in 18.4% of whites and 37.3% of blacks. Sodium-insensitive subjects had a higher rate of sodium excretion (p<0.001). Sodium-sensitive hypertensive subjects had a significantly greater weight gain (p<0.001). A significant correlation between blood pressure change and sodium excretion (r=-0.28, p<0.01) occurred in the sodiumsensitive group. The high sodium intake did not augment the blood pressure or heart rate response to the ^-adrenergic-mediated stimulus of mental arithmetic in the population when grouped by blood pressure, race, or sodium sensitivity. These results suggest that blood pressure increase in response to sodium load, particularly in blacks, is related to functional changes in peripheral vascular resistance. (Hypertension 1990;15:36-43) T he prevalence of hypertension is greater in black adults than in whites.

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Section: -29mentioning

confidence: 99%

Effect of chronic sodium loading on cardiovascular response in young blacks and whites.

1990

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“…Numerous investigators have demonstrated that acute volume expansion in patients with hypertension results in a more prompt rise in sodium excretion than is seen in the normotensive subject (1)(2)(3). This phenomenon, which has been referred to as an "exaggerated natriuresis," has been attributed both to decreased tubular sodium reabsorption (2,3) and to increased glomerular filtration rate (GFR) (2), but the intrarenal mechanisms have not been precisely defined.…”

Section: Introductionmentioning

confidence: 99%

“…This phenomenon, which has been referred to as an "exaggerated natriuresis," has been attributed both to decreased tubular sodium reabsorption (2,3) and to increased glomerular filtration rate (GFR) (2), but the intrarenal mechanisms have not been precisely defined.…”

Section: Introductionmentioning

confidence: 99%

Mechanism of exaggerated natriuresis in hypertensive man: impaired sodium transport in the loop of henle

Buckalew¹,

Puschett²,

Kintzel³

et al. 1969

J. Clin. Invest.

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A B S T R A C T To evaluate the effects of saline loading on distal sodium reabsorption in hypertensive man, studies were performed during both water deprivation and water diuresis in eight hypertensive subjects, and the results were compared to data obtained from similar studies in normal subjects. All hypertensive patients exhibited an enhanced excretion of filtered sodium (Ca/CIn) at any level of distal delivery of sodium compared to normal controls. Free water reabsorption (TCH2o) during hypertonic saline loading was quantitatively abnormal in the hypertensives at high levels of osmolar clearance (Co.m), and also the curve of TCHIo vs. Co.m leveled off above a Co.m of 18 ml/min per 1.73 m' in the hypertensive group in contrast to the normal controls in whom TCH,0o showed no evidence of achieving an upper limit. Sodium depletion exaggerated the abnormality in T'Ho in hypertensives, and resulted in a positive free water clearance (CH2o) during hydropenia.During hypotonic saline loading in water diuresis, changes in free water clearance per 100 ml of glomerular filtrate (CIo0/CI.) were less at any given increment in urine flow per 100 ml of glomerular filtrate (V/CG.) in the hypertensives compared to normal controls (P < 0.001). This abnormality in CH2o/CI. in the hypertensives in conjunction with the defect in T'H2o observed during hydropenia indicates that sodium reabsorption in the loop of Henle was abnormal at any given rate of distal delivery of sodium in hypertension. Furthermore, these abnormalities in TCH2o and CH20 coincided temporally with the development of the exaggerated natriuresis. Although the distal defect in sodium transport, in large part, accounted for the augmented natriuresis in hyperThis work was presented in part at the 1st Annual Meeting of the

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“…(Submitted for publication December 21, 1959; accepted January 8, 1960) Many studies indicate that patients with essential hypertension have a greater natriuretic response to rapidly administered sodium chloride solutions than have normotensive individuals (1)(2)(3)(4)(5)(6)(7). However, in most instances other factors known to influence the rate of sodium excretion in the normal subject such as diet, posture, and time of day have not been rigidly controlled (8,9).…”

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confidence: 99%

The Response to the Administration of an Isotonic Sodium Chloride-Lactate Solution in Patients With Essential Hypertension

Papper¹,

Belsky²,

Bleifer³

1960

J. Clin. Invest.

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Many studies indicate that patients with essential hypertension have a greater natriuretic response to rapidly administered sodium chloride solutions than have normotensive individuals (1-7). However, in most instances other factors known to influence the rate of sodium excretion in the normal subject such as diet, posture, and time of day have not been rigidly controlled (8, 9). Dietary control is of particular importance in view of observations suggesting that patients with hypertension may habitually ingest more salt than do normotensive individuals (10-11). If this is indeed the case it might well be responsible for the enhanced response of the hypertensive patient to administered salt.The present report is concerned with a comparison of the response of hypertensive and normotensive individuals to the intravenous administration of an "isotonic-balanced" salt solution under rigidly controlled conditions and at three different levels of dietary salt ingestion. The results indicate that patients with essential hypertension excrete the infused sodium load more rapidly than do normotensive individuals at each level of salt consumption. METHODSFour niormal Caucasian males aged 29 to 36 and 6 Caucasian patients aged 24 to 63 with essential hypertension were studied. The patients were selected on the basis of their maintaining a resting diastolic blood pressure of at least 100 mm Hg while hospitalized and consuming a diet containing approximately 10 mEq of sodium daily. Five of the 6 subjects were observed in this manner for 13 to 47 days prior to study, while Patient 8 received the low salt diet for 8 days prior to study. No patient had congestive heart failure, although no. 5 had

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Exaggerated natriuresis in essential hypertension

Cited by 148 publications

References 11 publications

Effect of chronic sodium loading on cardiovascular response in young blacks and whites.

Effect of chronic sodium loading on cardiovascular response in young blacks and whites.

Mechanism of exaggerated natriuresis in hypertensive man: impaired sodium transport in the loop of henle

The Response to the Administration of an Isotonic Sodium Chloride-Lactate Solution in Patients With Essential Hypertension

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