Document Detail


Salt supplementation improves orthostatic cerebral and peripheral vascular control in patients with syncope.
MedLine Citation:
PMID:  14981050     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Salt supplementation improves orthostatic tolerance in many patients with posturally related syncope (PRS). This study aimed to examine whether in those patients who responded to salt loading there was also evidence of improved cerebral autoregulation and more powerful peripheral vasoconstriction during orthostasis. Eleven PRS patients were studied before and after ingestion of 100 mmol/d slow sodium for 2 months. Subjects underwent an orthostatic stress test of combined head-up tilting and lower body suction. We continuously monitored heart rate (ECG), blood pressure (Finapres), forearm and cerebral blood flow velocities (Doppler ultrasound), and end-tidal carbon dioxide (CO2). Forearm vascular resistance was calculated from pressure divided by velocity. Cerebral autoregulation was assessed from the correlation coefficient of the relationship between cerebral blood pressure and velocity. Salt loading had no effect on resting heart rate or blood pressure. Symptoms and orthostatic tolerance significantly improved in 10 of the patients. This was associated with a significant increase in the maximal forearm vasoconstriction from 64.4%+/-13.7% (SEM) to 135.2%+/-23.9% (P<0.005). The relationship between cerebral velocity and pressure was less strong (before salt: r=0.74+/-0.8; after salt: r=0.41+/-0.1; P<0.02), indicating improved autoregulation. End-tidal CO2 levels were not different between the 2 tests. Salt loading in PRS patients increases orthostatic tolerance and improves cerebrovascular and peripheral vascular control without affecting blood pressures. These changes are likely to contribute to the beneficial effects of salt loading in these patients.
Authors:
Victoria E Claydon; Roger Hainsworth
Publication Detail:
Type:  Journal Article     Date:  2004-02-23
Journal Detail:
Title:  Hypertension     Volume:  43     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-26     Completed Date:  2004-08-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  809-13     Citation Subset:  IM    
Affiliation:
Institute for Cardiovascular Research, University of Leeds, Leeds, UK. v.e.claydon@leeds.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Flow Velocity / drug effects
Cerebrovascular Circulation / drug effects*,  physiology
Delayed-Action Preparations
Female
Hemodynamics / drug effects
Humans
Hypotension, Orthostatic / drug therapy*,  physiopathology
Lower Body Negative Pressure*
Male
Middle Aged
Posture
Sodium Chloride / administration & dosage,  pharmacology,  therapeutic use*
Syncope / drug therapy*,  physiopathology
Tilt-Table Test
Vascular Resistance / drug effects*
Vasoconstriction / drug effects
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 7647-14-5/Sodium Chloride

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


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