Changes in the circadian rhythm of blood pressure in primary aldosteronism in response to dietary sodium restriction and adrenalectomy
Authors:
- Masataka NishimuraMNMasataka Nishimura
- Takashi FujiiTFTakashi Fujii
- Masanobu TakejiMTMasanobu Takeji
- Setsuko KurodaSKSetsuko Kuroda
- Satoko NakamuraSNSatoko Nakamura
- Takashi InenagaTITakashi Inenaga
- Genjiro KimuraGKGenjiro Kimura
- 1 December 1998
- journal article
- research article
- Published by Wolters Kluwer Health in Journal Of Hypertension
- Vol. 16 (12) , 1745-1748
Abstract
Recently, we found that sodium restriction restored the circadian rhythm of blood pressure from non-dippers to dippers in patients with a sodium-sensitive type of essential hypertension. In the present study, we investigated the effects of sodium restriction on the circadian blood pressure rhythm in patients with primary aldosteronism, a typical sodium-sensitive form of secondary hypertension. We performed 24 h blood pressure monitoring in eight patients with primary aldosteronism due to unilateral adenoma (Conn's syndrome) during normal-sodium (7–12 g/day of NaCl) and low-sodium (1–3 g/day) diets, and after adrenalectomy. Sodium restriction lowered the 24 h mean arterial pressure from 116 ± 14 to 109 ± 12 mmHg (P < 0.01). During a normal-sodium diet, there was no change in systolic, diastolic and mean arterial pressures during the night-time compared with the daytime. In contrast, during a low-sodium diet, all night-time pressure values were significantly lower than those in the daytime. After adrenalectomy, the night-time pressures in patients on a normal-sodium diet were lower than those of the daytime. The nocturnal mean arterial pressure fall was increased by sodium restriction and adrenalectomy. These results indicate that the circadian rhythm of blood pressure was disturbed in patients with primary aldosteronism who maintained a relatively high sodium intake. Both adrenalectomy and sodium restriction restored a nocturnal dip in blood pressure in primary aldosteronism. Therefore, sodium restriction affects the circadian blood pressure rhythm in sodium-sensitive types of hypertension, not only in primary hypertension, but also in secondary hypertension.Keywords
This publication has 23 references indexed in Scilit:
- Sodium Restriction Shifts Circadian Rhythm of Blood Pressure From Nondipper to Dipper in Essential HypertensionCirculation, 1997
- Fourier analysis of circadian blood pressure profile in secondary hypertensionJournal of Human Hypertension, 1997
- High sodium sensitivity and glomerular hypertension/hyperfiltration in primary aldosteronismJournal Of Hypertension, 1996
- High Sodium Sensitivity Implicates Nocturnal Hypertension in Essential HypertensionHypertension, 1996
- Antihypertensive Mechanism of Diuretics Based on Pressure-Natriuresis RelationshipHypertension, 1996
- Nocturnal blood pressure in normotensive subjects and those with white coat, primary, and secondary hypertensionBMJ, 1994
- In Primary Aldosteronism the Circadian Blood Pressure Rhythm is Similar to That in Primary HypertensionClinical and Experimental Hypertension, 1994
- Circadian blood pressure variation in patients with renovascular hypertension or primary aldosteronisnClinical and Experimental Hypertension. Part A: Theory and Practice, 1992
- Renal function curve in patients with secondary forms of hypertension.Hypertension, 1987
- Circadian rhythm of blood pressure in primary aldosteronism and renovascular hypertension. Analysis by the cosinor method.Japanese Circulation Journal, 1983