Left Ventricular Mass Reduction by a Low-Sodium Diet in Treated Hypertensive Patients

Overview

Journal Nutrients

Date 2020 Dec 3

PMID 33266329

Citations 5

Authors

Natale Musso

Federico Gatto

Federica Nista

Andrea Dotto

Zhongyi Shen

Diego Ferone

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the left ventricular mass (LVM) reduction induced by dietary sodium restriction.

Patients And Methods: A simple sodium-restricted diet was advised in 138 treated hypertensives. They had to avoid common salt loads, such as cheese and salt-preserved meat, and were switched from regular to salt-free bread. Blood pressure (BP), 24-h urinary sodium (UNaV) and LVM were recorded at baseline, after 2 months. and after 2years.

Results: In 76 patients UNaV decreased in the recommended range after 2 months and remained low at 2 years. In 62 patients UNaV levels decreased after 2 months and then increased back to baseline at 2 years. Initially the two groups did not differ in terms of BP (134.3 ± 16.10 / 80.84 ± 12.23 vs.134.2 ± 16.67 / 81.55 ± 11.18 mmHg, mean ± SD), body weight (72.64 ± 15.17 vs.73.79 ± 12.69 kg), UNaV (161.0 ± 42.22 vs.158.2 ± 48.66 mEq/24 h), and LVM index (LVMI; 97.09 ± 20.42 vs.97.31 ± 18.91 g/m). After 2years. they did not differ in terms of BP (125.3 ± 10.69 / 74.97 ± 7.67 vs.124.5 ± 9.95 / 75.21 ± 7.64 mmHg) and body weight (71.14 ± 14.29 vs.71.50 ± 11.87 kg). Significant differences were seen for UNaV (97.3 ± 23.01 vs.152.6 ± 49.96 mEq/24 h) and LVMI (86.38 ± 18.17 vs.103.1 ± 21.06 g/m). Multiple regression analysis: UNaV directly and independently predicted LVMI variations, either as absolute values (R = 0.369; β = 0.611; < 0.001), or changes from baseline to +2years. (R = 0.454; β = 0.677; < 0.001). Systolic BP was a weaker predictor of LVMI (R = 0.369; β = 0.168; = 0.027; R = 0.454; β = 0.012; = 0.890), whereas diastolic BP was not correlated with LVMI. The prevalence of left ventricular hypertrophy decreased (29/76 to 15/76) in the first group while it increased in the less compliant patients (25/62 to 36/62; Chi = 0.002).

Conclusion: LVM seems linked to sodium consumption in patients already under proper BP control by medications.

Citing Articles

Association of triglyceride glucose-body mass index and left ventricular hypertrophy in patients with IgA nephropathy: a retrospective study.

Jv M, Zhang J, Han Y, Yang A, Zhu Y Eur J Med Res. 2024; 29(1):627.

PMID: 39726054 PMC: 11670427. DOI: 10.1186/s40001-024-02234-3.

Inverse Association between Exercising Blood Pressure Response and Left Ventricular Chamber Size and Mass in Women Who Habitually Resistance Train.

Matthews E, Guers J, Ramick M, Hosick P Healthcare (Basel). 2024; 12(3).

PMID: 38338238 PMC: 10855375. DOI: 10.3390/healthcare12030353.

Association between lifestyle modifications and improvement of early cardiac damage in children and adolescents with excess weight and/or high blood pressure.

Genovesi S, Tassistro E, Giussani M, Antolini L, Lieti G, Orlando A Pediatr Nephrol. 2023; 38(12):4069-4082.

PMID: 37349569 PMC: 10584714. DOI: 10.1007/s00467-023-06034-5.

Association of Urinary Sodium Excretion and Left Ventricular Hypertrophy in People With Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Liu J, Yang X, Zhang P, Guo D, Xu B, Huang C Front Endocrinol (Lausanne). 2021; 12:728493.

PMID: 34650519 PMC: 8505965. DOI: 10.3389/fendo.2021.728493.

Sodium Intake and Target Organ Damage in Hypertension-An Update about the Role of a Real Villain.

Nista F, Gatto F, Albertelli M, Musso N Int J Environ Res Public Health. 2020; 17(8).

PMID: 32325839 PMC: 7215960. DOI: 10.3390/ijerph17082811.

References

KEMPNER W . Some effects of the rice diet treatment of kidney disease and hypertension. Bull N Y Acad Med. 2010; 22:358-70. View

Mente A, ODonnell M, Rangarajan S, Dagenais G, Lear S, McQueen M . Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016; 388(10043):465-75. DOI: 10.1016/S0140-6736(16)30467-6. View

Du Bois D, Du Bois E . A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989; 5(5):303-11; discussion 312-3. View

Cailar G, Ribstein J, Mimran A . Dietary sodium and target organ damage in essential hypertension. Am J Hypertens. 2002; 15(3):222-9. DOI: 10.1016/s0895-7061(01)02287-7. View

Kong Y, Baqar S, Jerums G, Ekinci E . Sodium and Its Role in Cardiovascular Disease - The Debate Continues. Front Endocrinol (Lausanne). 2017; 7:164. PMC: 5179550. DOI: 10.3389/fendo.2016.00164. View

Selvaraj S, Djousse L, Aguilar F, Martinez E, Polsinelli V, Irvin M . Association of Estimated Sodium Intake With Adverse Cardiac Structure and Function: From the HyperGEN Study. J Am Coll Cardiol. 2017; 70(6):715-724. PMC: 5571737. DOI: 10.1016/j.jacc.2017.06.036. View

Jula A, Karanko H . Effects on left ventricular hypertrophy of long-term nonpharmacological treatment with sodium restriction in mild-to-moderate essential hypertension. Circulation. 1994; 89(3):1023-31. DOI: 10.1161/01.cir.89.3.1023. View

Devereux R, Alonso D, Lutas E, Gottlieb G, Campo E, Sachs I . Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986; 57(6):450-8. DOI: 10.1016/0002-9149(86)90771-x. View

Salvetti M, Paini A, Bertacchini F, Stassaldi D, Aggiusti C, Agabiti Rosei C . Changes in left ventricular geometry during antihypertensive treatment. Pharmacol Res. 2018; 134:193-199. DOI: 10.1016/j.phrs.2018.06.026. View

10.

Alves-Rodrigues E, Veras M, Rosa K, de Castro I, Furukawa L, Oliveira I . Salt intake during pregnancy alters offspring's myocardial structure. Nutr Metab Cardiovasc Dis. 2012; 23(5):481-6. DOI: 10.1016/j.numecd.2011.10.006. View

11.

Bkaily G, Simon Y, Menkovic I, Bkaily C, Jacques D . High salt-induced hypertrophy of human vascular smooth muscle cells associated with a decrease in glycocalyx. J Mol Cell Cardiol. 2018; 125:1-5. DOI: 10.1016/j.yjmcc.2018.10.006. View

12.

Lerchl K, Rakova N, Dahlmann A, Rauh M, Goller U, Basner M . Agreement between 24-hour salt ingestion and sodium excretion in a controlled environment. Hypertension. 2015; 66(4):850-7. PMC: 4567387. DOI: 10.1161/HYPERTENSIONAHA.115.05851. View

13.

Ferrara L, De Simone G, Pasanisi F, Mancini M . Left ventricular mass reduction during salt depletion in arterial hypertension. Hypertension. 1984; 6(5):755-9. DOI: 10.1161/01.hyp.6.5.755. View

14.

Whaley-Connell A, Habibi J, Aroor A, Ma L, Hayden M, Ferrario C . Salt loading exacerbates diastolic dysfunction and cardiac remodeling in young female Ren2 rats. Metabolism. 2013; 62(12):1761-71. PMC: 3833978. DOI: 10.1016/j.metabol.2013.08.010. View

15.

Ohta Y, Tsuchihashi T, Onaka U, Eto K, Tominaga M, Ueno M . Long-term compliance with salt restriction in Japanese hypertensive patients. Hypertens Res. 2006; 28(12):953-7. DOI: 10.1291/hypres.28.953. View

16.

Luft F, Morris C, Weinberger M . Compliance to a low-salt diet. Am J Clin Nutr. 1997; 65(2 Suppl):698S-703S. DOI: 10.1093/ajcn/65.2.698S. View

17.

Lang S, Ittleman B, Hahn E, Moore R, Khoury P, Ollberding N . Comparison of Left Ventricular Mass Calculation Methods via Two-Dimensional Echocardiogram in Children, Adolescents, and Young Adults With Systemic Hypertension. Am J Cardiol. 2019; 124(2):239-244. DOI: 10.1016/j.amjcard.2019.04.023. View

18.

Wang Q, Domenighetti A, Schafer S, Weber J, Simon A, Maillard M . Impact of salt on cardiac differential gene expression and coronary lesion in normotensive mineralocorticoid-treated mice. Am J Physiol Regul Integr Comp Physiol. 2012; 302(9):R1025-33. DOI: 10.1152/ajpregu.00387.2011. View

19.

Dunbar J . Practical aspects of dietary management of hypertension: compliance. Can J Physiol Pharmacol. 1986; 64(6):831-5. DOI: 10.1139/y86-143. View

20.

Nista F, Gatto F, Albertelli M, Musso N . Sodium Intake and Target Organ Damage in Hypertension-An Update about the Role of a Real Villain. Int J Environ Res Public Health. 2020; 17(8). PMC: 7215960. DOI: 10.3390/ijerph17082811. View