Document Detail


Low-sodium dietary approaches to stop hypertension diet reduces blood pressure, arterial stiffness, and oxidative stress in hypertensive heart failure with preserved ejection fraction.
MedLine Citation:
PMID:  23033371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies suggest that oxidative stress and vascular dysfunction contribute to heart failure with preserved ejection fraction (HFPEF). In salt-sensitive HFPEF animal models, diets low in sodium and high in potassium, calcium, magnesium, and antioxidants attenuate oxidative stress and cardiovascular damage. We hypothesized that the sodium-restricted Dietary Approaches to Stop Hypertension diet (DASH/SRD) would have similar effects in human hypertensive HFPEF. Thirteen patients with treated hypertension and compensated HFPEF consumed the DASH/SRD for 21 days (all food/most beverages provided). The DASH/SRD reduced clinic systolic (155-138 mm Hg; P=0.02) and diastolic blood pressure (79-72 mm Hg; P=0.04), 24-hour ambulatory systolic (130-123 mm Hg; P=0.02) and diastolic blood pressure (67-62 mm Hg; P=0.02), and carotid-femoral pulse wave velocity (12.4-11.0 m/s; P=0.03). Urinary F2-isoprostanes decreased by 31% (209-144 pmol/mmol Cr; P=0.02) despite increased urinary aldosterone excretion. The reduction in urinary F2-isoprostanes closely correlated with the reduction in urinary sodium excretion on the DASH/SRD. In this cohort of HFPEF patients with treated hypertension, the DASH/SRD reduced systemic blood pressure, arterial stiffness, and oxidative stress. These findings are characteristic of salt-sensitive hypertension, a phenotype present in many HFPEF animal models and suggest shared pathophysiological mechanisms linking these 2 conditions. Further dietary modification studies could provide insights into the development and progression of hypertensive HFPEF.
Authors:
Scott L Hummel; E Mitchell Seymour; Robert D Brook; Theodore J Kolias; Samar S Sheth; Hannah R Rosenblum; Joanna M Wells; Alan B Weder
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-01
Journal Detail:
Title:  Hypertension     Volume:  60     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-18     Completed Date:  2013-01-10     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1200-6     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, 1500 East Medical Center Dr, CVC Room 2383, SPC 5853, Ann Arbor, MI 48109, USA. scothumm@med.umich.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Pressure / physiology
Diet, Sodium-Restricted*
F2-Isoprostanes / urine
Female
Heart Failure / complications,  diet therapy*,  physiopathology*
Humans
Hypertension / complications,  diet therapy*,  physiopathology*
Male
Middle Aged
Oxidative Stress / physiology
Sodium / urine
Time Factors
Treatment Outcome
Vascular Stiffness / physiology
Grant Support
ID/Acronym/Agency:
1K23HL109176/HL/NHLBI NIH HHS; K23 HL109176/HL/NHLBI NIH HHS; UL1R000433//PHS HHS
Chemical
Reg. No./Substance:
0/F2-Isoprostanes; 7440-23-5/Sodium
Comments/Corrections

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