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Salt sensitive hypertension

N Kantaria, I Pantsulaia, I Andronikashvili, G Simonia
This investigation differentiates types of essential hypertension in a Georgian population as well as describes endogenous cardiotonic steroids in salt-sensitive and salt-resistant subjects. This case control study included 185 subjects: 94 cases with stage 1 essential hypertension (JNC7) naïve to antihypertensive treatment, and 91 controls. A salt-sensitivity test was used to dichotomize case and control groups into salt-sensitive and salt-resistant subgroups. Blood and urine samples were obtained to categorize participants as consuming high and low salt diets...
September 2016: Georgian Medical News
N Kantaria, I Pantsulaia, I Andronikashvili, G Simonia
It has been known that salt-sensitivity of blood pressure is defined genetically as well as can be developed secondary to either decreased renal function or by influence of other environmental factors. The aim of the study was to evaluate the possible mechanism for the development of salt-sensitive essential hypertension in the population of Georgia. The Case-Control study included 185 subjects, 94 cases with Essential Hypertension stage I (JNC7) without prior antihypertensive treatment, and 91 controls. Salt-sensitivity test was used to divide both case and control groups into salt-sensitive (n=112) and salt-resistant (n=73) subgroups...
September 2016: Georgian Medical News
Shigeru Shibata, Kenichi Ishizawa, Shunya Uchida
The kidney has a central role in long-term control of blood pressure, and decreased kidney function is a common but difficult-to-treat cause of hypertension. Conversely, elevated blood pressure contributes to the progression of chronic kidney disease. Steroid hormone aldosterone and its receptor mineralocorticoid receptor (MR) contribute to hypertension by increasing renal salt reabsorption and promote kidney dysfunction through direct effects on renal parenchymal cells. Accumulating data indicate that various mechanisms affect aldosterone-MR signaling...
October 20, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Petra Rust, Cem Ekmekcioglu
Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown...
October 19, 2016: Advances in Experimental Medicine and Biology
Zhiming Zhu
Management of hypertension in diabetes is critical for reducing cardiovascular mortality and morbidity. Dietary approaches for controlling high blood pressure have historically focused on sodium. Thus, many guidelines recommend that patients with type 2 diabetes reduce high sodium intake. Nonetheless, the potential benefits of sodium reduction are debatable. The kidney has a crucial role in glucose filtration and reabsorption in addition to its regulation of fluid and electrolyte homeostasis. A key factor linking sodium uptake and glucose transport is the sodium-glucose cotransporter 2 (SGLT2) in renal proximal tubular cells...
September 2016: Journal of Hypertension
Liffert Vogt
Excessive sodium intake is associated with both hypertension and an increased risk of cardiovascular events, presumably because of an increase in extracellular volume. The extent to which sodium intake affects extracellular volume and BP varies considerably among individuals, discriminating subjects who are salt-sensitive from those who are salt-resistant. Recent experiments have shown that, other than regulation by the kidney, sodium homeostasis is also regulated by negatively charged glycosaminoglycans in the skin interstitium, where sodium is bound to glycosaminoglycans without commensurate effects on extracellular volume...
September 2016: Journal of Hypertension
Richard Wainford
This lecture will provide a background on the physiology of renal sodium handling and its importance in long term blood pressure regualtion. A brief overview of the classical Guytonion Pressure-Natriuresis Hypothesis of blood pressure control will be provided. The global impact of dietary salt intake on hypertension incidence and cardiovasular health will be discussed. Addtionally, recent insights into the mechanisitc regualtion of renal sodium handling during health and the pathophysiology of salt-sensitive hypertension - including a focus on the regulation of the sodium chloride cotransport will be provided...
September 2016: Journal of Hypertension
Marko Poglitsch, Ashraf H Ahmed, Andrea Stoller, Dunja Van Oyen, Cornelia Schwager, Claudia Aigner, Oliver Domenig, Manuel Haschke, Michael Stowasser
OBJECTIVE: Primary aldosteronism (PA) is a widely under-diagnosed, potentially curable and specifically treatable cause of hypertension. PA screening involves measuring the aldosterone-to-renin-ratio (ARR), but false negative results can occur in the setting of medications, which block the renin-angiotensin system (RAS). Withdrawing RAS blockers from patients with resistant hypertension is not without cardiovascular risk. A novel diagnostic approach, the aldosterone-to-angiotensin-II-ratio (AA2-Ratio), has the potential for less drug interference and improved reliability in PA screening and confirmation of diagnosis...
September 2016: Journal of Hypertension
Toshiro Fujita
The aldosterone/mineralocorticoid receptor (MR) pathway regulate renal excretory function and control BP. Notably, we identified Rac1 as a novel ligand-independent modulator of MR (Nat Med 2008), and found involvement of the Rac1-MR pathway in rodent models of salt-sensitive hypertension (JCI 2011). In the clinical trial (EVALUATE study), effects of MR antagonist on urinary albumin excretion were assessed in 304 hypertensive CKD patients receiving renin-angiotensin system (RAS) inhibitors and sub-grouped according to the estimated dietary salt intake (Lancet Endo & Diabetes 2014)...
September 2016: Journal of Hypertension
Ernesto Schiffrin
For many years we have studied models of hypertension in which endothelin-1 (ET-1) is overexpressed. These include DOCA-salt hypertensive rats, Dahl-salt sensitive rats, and stroke prone SHR, in all of which ET-1-mediated mechanisms play a role in blood pressure elevation and vascular injury. In humans we demonstrated overexpression of ET-1 in the endothelium of small arteries from stage 2 hypertensive patients. We have also produced a mouse that overexpresses human ET-1 in the endothelium using a Tie-2 promoter, which exhibited increased oxidative stress and inflammation, hypertrophic remodeling and endothelial dysfunction of small arteries but only slight blood pressure elevation...
September 2016: Journal of Hypertension
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Richard Wainford, Kathryn Walsh
OBJECTIVE: These studies tested the hypothesis that the SNS release of norepinephrine modulates NCC activity via a WNK1 mechanism to contribute to the pathophysiology of salt-sensitive hypertension in rats. DESIGN AND METHOD: Male Sprague-Dawley (SD) rats receiving a continuous s.c. saline or NE (600 ng/min) infusion or naïve Dahl Salt-Resistant (DSR) and Dahl Salt-Sensitive (DSS) rats were fed a 0.6% (NS) or 8% NaCl (HS) diet for 14 or 21 days respectively (N = 6/group)...
September 2016: Journal of Hypertension
Mitsuha Morisaki, Isao Kurihara, Sakiko Kobayashi, Kenichi Yokota, Ayano Murai-Takeda, Rie Jo, Yuko Mitsuishi, Toshifumi Nakamura, Nao Kohata, Yosuke Oshima, Hirotaka Shibata, Hiroshi Itoh
OBJECTIVE: It has been reported that obesity-related high blood pressure was partly associated with increased aldosterone secretion and/or activity, but detailed mechanisms are not known. Our previous study suggested that different salt contents in each diet would affect the aldosterone levels. In this study, we investigated the change of aldosterone secretion and MR sensitivity of obesity mice by high fat diet under equally-adjusted salt intake. DESIGN AND METHOD: We prepared normal fat diet (NFD, 10% lard) and high fat diet (HFD, 60% lard) with equal amount of salt based on the amount of food intake of C57BL/6J mice...
September 2016: Journal of Hypertension
Akira Nishiyama, Abu Sufiun, Yoshihide Fujisawa, Asadur Rahman, Daisuke Nakano, Hirofumi Hitomi
OBJECTIVE: It has been indicated that non-dipper pattern of circadian rhythm of blood pressure (BP) is a great risk of cardiovascular disease, which is accompanied by impaired renal function and proteinuria. Here, we aimed to investigate the circadian rhythm of BP during the progression of renal injury in Dahl salt-sensitive (DSS) hypertensive rats. DESIGN AND METHOD: DSS rats were treated with a high salt diet (HS; 8% NaCl) for 10 weeks (n = 10). RESULTS: Before starting a HS diet, the difference in mean arterial pressure (MAP) between dark and light period was 6...
September 2016: Journal of Hypertension
Gheun-Ho Kim, Chor Ho Jo, Sua Kim, Il Hwan Oh, Joon-Sung Park
OBJECTIVE: Claudins are tight junction proteins that regulate paracellular permeability of renal epithelia, and renal paracellular sodium chloride permeability may be essential to salt homeostasis and blood pressure control. A previous study has shown that the collecting duct-specific claudin-4 knockout animals develop hypotension due to profound renal wasting of chloride. This study was undertaken to investigate whether claudins have a role in the hypertension of Dahl salt-sensitive (DS) rats...
September 2016: Journal of Hypertension
Francisco J Rios, Katie Y Hood, A Karvey, Karla B Neves, Panagiota Anyfanti, Ryszard Nosalski, Livia L Camargo Ll, Augusto C Montezano, Rhian M Touyz
OBJECTIVE: TRPM7 is cation channel with intrinsic kinase activity important for cellular Mg homeostasis. We recently showed that TRPM7-kinase plays a role in aldosterone-mediated vascular effects and inflammation. Here we explored the putative role of TRPM7-kinase in cardiac fibrosis and vascular function in aldosterone-induced hypertension in mice. DESIGN AND METHOD: Wild-type (WT) or heterozygote TRPM7-kinase domain (TRPM7+/-) mice were treated with infused aldosterone (600 μg/Kg/day) and NaCl 1% in drinking water (aldo/salt) for 4 weeks...
September 2016: Journal of Hypertension
Kaoru Yamashita, Atsuhiro Ichihara, Kentaro Ito, Naohiro Yoshida, Fumiko Mitani, Jin Endo, Motoaki Sano, Keiichi Fukuda, Satoshi Morimoto
OBJECTIVE: Numerous clinical trials demonstrated that renin-angiotensin-aldosterone system (RAAS) was involved in the pathogenesis of hypertension-induced heart failure. While RAS is a major machinery required for aldosterone production, multiple minor systems, including catecholamine, could give rise to the aberrant aldosterone production beyond the RAS activation. We investigated the mechanism underlying the RAS-independent aldosterone production in heart failure. DESIGN AND METHOD: Dahl-salt sensitive rats fed high salt diet developed malignant hypertension, resulting in heart failure with inappropriately increased plasma aldosterone level...
September 2016: Journal of Hypertension
Ayako Uchinaka, Yuri Kawashima, Yuki Sano, Mamoru Yoneda, Shogo Ito, Yusuke Sano, Kai Nagasawa, Natsumi Matsuura, Yuichiro Yamada, Toyoaki Murohara, Kohzo Nagata
OBJECTIVE: The pineal hormone melatonin, which regulates the body's circadian rhythm, possesses anti-oxidative and anti-inflammatory effects and thereby improves metabolic disorders. Ramelteon is a potent and highly selective agonist of melatonin receptors and attenuates age-associated hypertension and body weight gain in spontaneously hypertensive rats. However, the effects of ramelteon on cardiovascular and metabolic disorders in metabolic syndrome (MetS) remain unclear. We investigated the effects of ramelteon on cardiac and adipose tissue pathology in a rat model of MetS...
September 2016: Journal of Hypertension
Hiroshi Itoh
Many hypertension guidelines have been published mainly from Western countries to standardize the management of hypertension all over the world, however, the significance of hypertension, along with other cardio-metabolic risks, such as obesity, diabetes or dyslipidemia should differ among different races. This paper compares the relevance of hypertension, one of the most important cardio-metabolic risk factors, in Asian and Western societies.1) Low target level of blood pressure control for diabetic hypertensives in JapanIn the Japanese Society of Hypertension Guidelines for the management of Hypertension (JSH2014), the target of blood pressure (BP) control in hypertensive patients with diabetes was set as < 130/80 mmHg...
September 2016: Journal of Hypertension
George Bakris
Resistant hypertension is defined as a blood pressure above 140/90 mmHg despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease (CKD) is one of the more common patient comorbidities associated with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. CKD is associated with premature vascular ageing, characterized by accelerated arteriosclerosis or atherosclerosis and endothelial dysfunction...
September 2016: Journal of Hypertension
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