Nutr Res Pract.  2016 Jun;10(3):288-293. 10.4162/nrp.2016.10.3.288.

Elevation of heart-femoral pulse wave velocity by short-term low sodium diet followed by high sodium diet in hypertensive patients with sodium sensitivity

• Rhee MY
• Kim JH
• Na SH
• Chung JW
• Bae JH
• Nah DY
• Gu N
• Kim HY

• KMID: 2342131
• DOI: http://doi.org/10.4162/nrp.2016.10.3.288

Abstract

BACKGROUND/OBJECTIVES
We compared changes in heart-femoral pulse wave velocity (hfPWV) in response to low sodium and high sodium diet between individuals with sodium sensitivity (SS) and resistance (SR) to evaluate the influence of sodium intake on arterial stiffness.
SUBJECTS/METHODS
Thirty-one hypertensive and 70 normotensive individuals were given 7 days of low sodium dietary approach to stop hypertension (DASH) diet (LSD, 100 mmol NaCl/day) followed by 7 days of high sodium DASH diet (HSD, 300 mmol NaCl/day) during 2 weeks of hospitalization. The hfPWV was measured and compared after the LSD and HSD.
RESULTS
The hfPWV was significantly elevated from LSD to HSD in individuals with SS (P = 0.001) independently of changes in mean arterial pressure (P = 0.037). Conversely, there was no significant elevation of hfPWV from LSD to HSD in individuals with SR. The percent change in hfPWV from the LSD to the HSD in individuals with SS was higher than that in individuals with SR. Subgroup analysis revealed that individuals with both SS and hypertension showed significant elevation of hfPWV from LSD to HSD upon adjusted analysis using changes of the means arterial pressure (P = 0.040). However, there was no significant elevation of hfPWV in individuals with SS and normotension.
CONCLUSION
High sodium intake elevated hfPWV in hypertensive individuals with SS, suggesting that high sodium intake increases aortic stiffness, and may contribute to enhanced cardiovascular risk in hypertensive individuals with SS.

Keyword

Dietary sodium; hypertension; vascular sensitivity

MeSH Terms

Arterial Pressure
Diet*
Hospitalization
Humans
Hypertension
Lysergic Acid Diethylamide
Pulse Wave Analysis*
Sodium*
Sodium, Dietary
Vascular Stiffness
Lysergic Acid Diethylamide
Sodium
Sodium, Dietary

Figure

• 

  Fig. 1 Heart-femoral pulse wave velocity (hfPWV) values at baseline, after 7 days of the low sodium DASH diet (LSD), and after 7 days of a high sodium DASH diet (HSD). (A) No difference in hfPWV values was observed between sodium sensitive (SS) and sodium resistant (SR) individuals after adjusting for age, gender, body mass index (BMI), mean arterial pressure (MAP), fasting blood glucose level, and total cholesterol level (analysis of covariance P > 0.05). Individuals with SS showed a higher value of hfPWV after 7 days of the HSD compared to that after 7 days of the LSD, both in the unadjusted (paired t-test P = 0.001) and adjusted analysis (one-way repeated measures analysis of variance adjusted with change of MAP P = 0.037). (B) Hypertensive individuals (HT) had a higher hfPWV value than normotensive individuals (NT) after 7 days of the LSD and HSD in adjusted analysis for confounders (analysis of covariance P = 0.034 and 0.006, respectively). HT showed a higher value of hfPWV after 7 days of the HSD than after 7 days of the LSD upon unadjusted analysis (paired t-test P = 0.046), but not adjusted analysis (one-way repeated measures analysis of variance adjusted with change of MAP P = 0.210). The difference in hfPWV values between groups was analyzed by analysis of covariance, adjusted with age, gender, BMI, heart rate, MAP obtained simultaneously during the measurement of hfPWV, fasting blood glucose, and total cholesterol. The change in hfPWV from LSD to HSD was analyzed by one-way repeated-measures analysis of variance adjusted with the change of MAP, which was obtained simultaneously during measurement of hfPWV.

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  Fig. 2 Percent changes in heart-femoral pulse wave velocity (hfPWV) in each group. The percent change in sodium sensitive individuals (SS) was higher than that in sodium resistant individuals (SR). No significant difference in the percent change in hfPWV was observed between hypertensive (HT) and normotensive individuals (NT). The percentchangesin hfPWV between groups (SS vs. SR, and HT vs. NT) were compared by analysis of covariance using age, gender, body mass index, mean arterial pressure, fasting blood glucose level, and total cholesterol level as covariates.

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