Influence of short-time application of a low sodium diet on blood pressure in patients with hyperthyroidism or hypothyroidism during therapy

Marcisz, C; Jonderko, G; Kucharz, Eugene J.

doi:10.1016/s0895-7061(01)02186-0

Cited by 23 publications

(12 citation statements)

References 22 publications

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“…[25][26][27] Blood pressure salt sensitivity was also one of the critical factors for hypertension in hypothyroid patients. 28 The study by Gumieniak et al 25 showed that the relationship between free thyroxine index (FTI) and salt sensitivity is partly mediated by the vascular action of the thyroid hormone. Recent studies indicate that cardiovascular disorders have existed in the subclinical hypothyroidism stage.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

2011

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The relationship between subclinical thyroid dysfunction and blood pressure is controversial and has received insufficient attention. The aim of this study was to assess whether blood pressure levels in patients with subclinical thyroid dysfunction differ from those of euthyroid subjects. A meta-analysis of all cross-sectional studies was performed to compare the blood pressure levels in patients with subclinical thyroid dysfunction with those of healthy controls. A computer-based online retrieval of databases (MEDLINE and EMBASE) and manual searches were undertaken to identify articles that addressed the association between subclinical thyroid dysfunction and blood pressure levels and were published through 2010, using no language restrictions. The meta-analysis was performed using STATA 11 (Stata). Seven cross-sectional studies were examined. In patients with subclinical hypothyroidism, the pooled estimate of the weighted mean difference (WMD) of increased blood pressure revealed a significant difference in both systolic blood pressure (SBP; WMD with 95% confidence interval (CI) 1.89 mm Hg (0.98-2.80), Po0.05) and diastolic blood pressure (DBP; WMD with 95% CI 0.75 mm Hg (0.24-1.27), Po0.05). However, in patients with subclinical hyperthyroidism, the pooled estimate of the WMD of increased blood pressure revealed no significant difference in SBP (WMD with 95% CI À0.75 mm Hg (À1.81 to 0.31)) or DBP (WMD with 95% CI À0.64 mm Hg (À2.36 to 1.08)). The present meta-analysis indicates that subclinical hypothyroidism is associated with increased SBP and DBP, whereas subclinical hyperthyroidism is not. Further investigation is needed to confirm blood pressure levels in patients with subclinical thyroid dysfunction.

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Section: Discussionmentioning

confidence: 99%

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

2011

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“…20 Substantial alterations in REE occur in hypothyroidism and hyperthyroidism, and in both instances elevated BP is commonly observed. 21,22 The implications of thyroid disease, with a variety of other associated effects, for normal variation in REE is difficult to judge, however. REE may reflect sympathetic tone, although measurement of various compartment effects is challenging.…”

Section: Discussionmentioning

confidence: 99%

Association Between Blood Pressure and Resting Energy Expenditure Independent of Body Size

et al. 2004

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Abstract-Obesity is an important risk factor for hypertension; however, the pathway through which it raises blood pressure (BP) is poorly understood. Body size is also the primary determinant of energy expenditure, and we therefore examined the joint relationship of energy expenditure and body size to blood pressure. Resting energy expenditure (REE) was measured using respiratory gas exchange in population-based samples of 997 Nigerians and 452 African Americans. In a third sample of 118 individuals, nonresting energy expenditure (ie, physical activity) was measured in addition to REE. The univariate correlation between REE and BP ranged from 0.10 to 0.22 in the 3 samples (PϽ0.001).In multivariate models, adiposity, whether defined by body mass, fat mass, or leptin, was no longer associated with BP, while REE remained highly significant (PϽ0.001). The REE-BP association also persisted after adjustment for physical activity measured with doubly labeled water. The odds ratio for hypertension among persons in the highest quartile versus the lowest quartile of REE, after adjustment for body size, was 1.7. This relationship was not the result of hypertension among the obese, because it did not vary across the range of BMI and was the same in lean Nigerians as in obese Americans. These data suggest that metabolic processes represented by REE may mediate the effect of body size on BP. The interrelationship of REE with sympathetic tone, transmembrane ion exchange, or other metabolic processes that determine energy costs at rest could provide physiological explanations for this observation. . Although height appears to have little or no influence on BP among humans, adiposity has been universally identified as a predictor of increased risk of hypertension. 1,2 Despite substantial efforts, the underlying physiological mechanisms linking excess body fat stores to BP are poorly understood. Obesity is a complex syndrome, representing the joint effect of metabolic alterations as well as lifestyle patterns that involve, among others, a high-calorie/highsodium intake and reduced physical activity. 3 Various regulatory hormones, including insulin and leptin, are increased among the obese, and abnormalities in the renin-angiotensin system have been described. 4 -6 At the same time, a wide range of other metabolic abnormalities, including rates of ion transport and resting sympathetic tone, have been reported in obese hypertensives compared with the non-obese, although these associations are inconsistent. 7 An important challenge faced by studies that attempt to isolate the role of individual components of body composition and energy metabolism is the need to account for their intercorrelation. Although it is often assumed that the size of body fat stores is a primary determinant of hypertension risk, lean body mass increases in parallel with total body weight and is highly correlated with fat mass. 8 In addition, in societies where virtually the entire population experiences some degree of overweight, it may be difficult to iden...

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“…Interestingly, preclinical studies have shown that sodium-restricted diets significantly decrease the plasma levels of ANP in rats after 1 or 3 weeks (36). Sodium restriction in patients with thyroid disease also decreased plasma ANP levels, but this did not reach statistical significance (37). In this study, three patients with SCLC presented with hyponatremia and elevated ANP levels and, after 4 days of sodium restriction, no significant declines in plasma ANP levels could be detected, suggesting ectopic production of ANP in these patients.…”

Section: Discussionmentioning

confidence: 95%

A Metabolic Study of Patients with Lung Cancer and Hyponatremia of Malignancy

Chute

Taylor

et al. 2006

Clinical Cancer Research

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Purpose: One-third of patients with lung cancer and hyponatremia have no evidence of ectopic arginine vasopressin (AVP) production and the cause of their hyponatremia is not conclusively established.We sought to distinguish patients with hyponatremia caused by elevated AVP versus those with ectopic atrial natriuretic peptide (ANP) via this detailed metabolic study. Experimental Design: We enrolled 24 patients recently diagnosed with lung cancer in a metabolic study in which patients were placed on sodium and fluid restriction for 4 days. Serum electrolytes, osmolality, urine electrolytes and osmolality, plasma AVP, ANP, aldosterone, urinary cyclic AMP and cyclic guanosine 3V,5V-monophosphate were measured daily and tumor tissue was obtained to measure ectopic hormone production.We attempted to characterize the pathophysiology of hyponatremia caused by ectopic ANP production in patients with small cell lung cancer (SCLC) and to determine its effect on the aldosterone axis. Results: Seven of the nine patients with SCLC presented with hyponatremia and three had elevated ANP levels at presentation without elevation of AVP. All three patients who presented with hyponatremia and elevated ANP showed a decline in serum sodium following fluid restriction, whereas two patients with SCLC and elevated AVP had normalized serum sodium levels. The combination of hyponatremia and elevated ANP was associated with a persistent natriuresis and inappropriately low aldosterone levels despite sodium restriction, suggesting ANP suppression of the aldosterone axis. Conclusions: Management of patients with hyponatremia and SCLC should be guided by the knowledge that some patients with SCLC have ectopic production of ANP as the cause of their hyponatremia.

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Influence of short-time application of a low sodium diet on blood pressure in patients with hyperthyroidism or hypothyroidism during therapy

Cited by 23 publications

References 22 publications

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data

Association Between Blood Pressure and Resting Energy Expenditure Independent of Body Size

A Metabolic Study of Patients with Lung Cancer and Hyponatremia of Malignancy

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