Salt intake and blood pressure response to percutaneous renal denervation in resistant hypertension

The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP‐lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, symp...

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Vydáno v:	The journal of clinical hypertension (Greenwich, Conn.) Ročník 19; číslo 11; s. 1125 - 1133
Hlavní autoři:	Beus, Esther, Jager, Rosa L., Beeftink, Martine M., Sanders, Margreet F., Spiering, Wilko, Vonken, Evert‐Jan, Voskuil, Michiel, Bots, Michiel L., Blankestijn, Peter J., Elgersma, O, IJsselmuiden, AJJ, Valk, PHM, Smak Gregoor, P, Roodenburg, S, Meuwissen, M, Dewilde, W, Hunze, I, Hollander, J, Vincent, HH, Rensing, B, Bos, WJ, Weverwijk, I, Tonino, PAL, Brueren, BRG, Konings, CJAM, Gompel, H Hendrix‐van, Heeg, JE, Lambert, J, Smit, JJ, lvan, A, Berends, A, Jager, B, Laverman, G, Vries, PAM, Balen, A, Stoel, M, Steggerda, R, Niamut, L, Bossen, W, Biermann, J, Knot, I, Peels, JOJ, Swart, JB, Kimman, G, Bax, W, Meij, Y, Reekers, J, Wardeh, AJ, Groeneveld, JHM, Dille, C, Hemmelder, MH, Folkeringa, R, Sietzema, M, Wassenaar, C, Parlevliet, K, Aengevaeren, W, Tjon, M, Hovens, M, Berg, A, Monajemi, H, Kleij, FGH, chramm, A, Wiersum, A, Kroon, B, Haan, M, Das, M, Jongen, H, Herben, E, Rennenberg, R, Blankestijn, PJ, Bots, ML, Dijker, B, Frederix, GWJ, Jager, RL, Maarseveen, E, Sanders, MF, Spiering, W, Velikopolskaia, IS, Vendrig, L, Verloop, WL, Vink, EE, Vonken, EPA, Wit, GA, Vincent, J, Roes, CB, Deinum, J, Rabelink, AJ, Lenders, J, Eijkemans, R
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States John Wiley and Sons Inc 01.11.2017
Témata:	Aged Antihypertensive Agents - therapeutic use Blood Pressure - drug effects Blood Pressure Monitoring, Ambulatory - methods dietary sodium Drug Resistance Female Humans hypertension Hypertension - diagnosis Hypertension - metabolism Hypertension - physiopathology Hypertension - surgery Kidney - innervation Kidney - physiopathology Male Middle Aged Original Paper Renal Denervation salt sensitivity Sodium - urine Sodium Chloride, Dietary - metabolism sodium intake Sympathectomy - adverse effects Sympathectomy - methods Sympathetic Nervous System - drug effects Sympathetic Nervous System - physiopathology Treatment Outcome renal denervation sodium intake hypertension dietary sodium salt sensitivity
ISSN:	1524-6175, 1751-7176, 1751-7176
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Popis
Shrnutí:	The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP‐lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24‐hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension. Both 24‐hour ambulatory and office BP measurements were end points. No relationship was found for baseline sodium excretion and change in BP 6 months after RDN in multivariable‐adjusted regression analysis. Change in the salt intake–measured BP relationships at 6 months vs baseline was used as a measure for salt sensitivity. BP was 8 mm Hg lower with similar salt intake after RDN, suggesting a decrease in salt sensitivity. However, the change was similar in the control group, and thus not attributable to RDN.
Bibliografie:	Funding information SYMPATHY is an investigator‐driven trial and received unrestricted grants from the Netherlands Organisation for Health Research and Development (ZonMw, No. 837004006), the Dutch Kidney Foundation (Nierstichting Nederland, No. CPI12.02), and Medtronic Inc. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1524-6175 1751-7176 1751-7176
DOI:	10.1111/jch.13085