The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity

Peter K Bonfils, Mustafa Taskiran, Morten Damgaard, Jens P Goetze, Andrea K Floyd, Peter Funch-Jensen, Viggo B Kristiansen, Niels Gadsbøll

8 Citations (Scopus)

Abstract

Background: Many patients with morbid obesity (BMI >  40 kg/m) have hypertension. The complex pathophysiological abnormalities linking hypertension to obesity have not been fully clarified, but abnormal sodium handling could be an important mechanism.Method: Therefore, we examined changes in body fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90 mmol/day) and 5 days of a high-sodium diet (250 mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls.Results: High sodium intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5 ±â€Š4%; obese, normotensive patients: 10 ±â€Š11%; nonobese controls: 7 ±â€Š6%), cardiac output (CO) (obese, hypertensive patients: 17 ±â €Š12%; obese, normotensive patients: 20 ±  16%; nonobese controls: 13 ±  14%) and stroke volume (SV) (obese, hypertensive patients: 27 ±â€Š26%; obese, normotensive patients: 27 ±â€Š24%; nonobese controls: 18 ±â€Š27%) in all three groups with no differences between the groups. Despite an increase in CO during high salt intake, 24-h blood pressure (BP) was unchanged in patients and controls as a result of a reduction in total peripheral resistance (obese, hypertensive patients: -11 ±â€Š11%; obese, normotensive patients: - 10 ±â€Š12%; nonobese controls: -5 ±â€Š14%). Similar changes were observed during an incremental bicycle exercise test wherein CO and SV were higher, whereas mean arterial BP was unchanged at each exercise level during high sodium intake.Conclusion: Despite substantial increases in CO and SV, we did not observe any significant change in BP during high sodium intake, neither in morbid obese patients nor in lean individuals.

Original languageEnglish
JournalJournal of Hypertension
Volume31
Issue number11
Pages (from-to)2220-9; discussion 2229
Number of pages11
ISSN0263-6352
DOIs
Publication statusPublished - Nov 2013

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