Document Detail


Salt sensitivity and circadian rhythm of blood pressure: the keys to connect CKD with cardiovascular events.
MedLine Citation:
PMID:  20379191     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In healthy subjects, blood pressure (BP) drops by 10-20% during the night. Conversely, in patients with the salt-sensitive type of hypertension or chronic kidney disease, nighttime BP does not fall, resulting in an atypical pattern of circadian BP rhythm that does not dip. This pattern is referred to as the 'non-dipper' pattern. Loss of renal functional reserve, due to either reduced ultrafiltration capacity or enhanced tubular sodium reabsorption, induces the salt-sensitive type of hypertension. When salt intake is excessive in patients with salt-sensitive hypertension, the defect in sodium excretory capability becomes evident, resulting in elevated BP during the night. This nocturnal hypertension compensates for diminished natriuresis during the daytime and enhances pressure natriuresis during the night. Nocturnal hypertension and the non-dipper pattern of circadian BP rhythm cause cardiovascular events. When excess salt intake is loaded in patients who are in a salt-sensitive state, glomerular capillary pressure is also elevated, resulting in glomerular sclerosis and eventual renal failure. In this way, salt sensitivity and excess salt intake contribute to both cardiovascular and renal damage at the same time. We propose that salt sensitivity of BP and excess salt intake have important roles in the genesis of the cardiorenal connection. Salt sensitivity and circadian rhythm of BP are the keys to understanding the connections between cardiovascular and renal complications.
Authors:
Genjiro Kimura; Yasuaki Dohi; Michio Fukuda
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-04-09
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  33     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-04     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  515-20     Citation Subset:  IM    
Affiliation:
Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / physiology*
Cardiovascular Diseases / etiology,  physiopathology
Chronic Disease
Circadian Rhythm / physiology*
Female
Humans
Hypertension / etiology*,  physiopathology
Kidney Diseases / physiopathology*
Male
Salt-Tolerance*
Sodium Chloride, Dietary / adverse effects*
Stroke / etiology,  physiopathology
Chemical
Reg. No./Substance:
0/Sodium Chloride, Dietary

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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