Sodium

NA: Method for Measuring Blood Pressure Response (2009)

• Assessment
  What is the optimal method for measuring blood pressure response in adults and children to dietary sodium intake in the clinical setting (i.e., determining an individual's salt-sensitivity)?

  • Conclusion

    Depletion and loading methods were used for determining salt sensitivity in the clinical setting. A significant relationship of blood pressure (BP) response to salt/sodium (Na) depletion and load was observed. In adults with varying levels of BP, a dietary or an intravenous (IV) method of Na depletion (10 to 50mmol per day, three days or less) and Na loading (150 to 400mmol per day, three days or more), both with BP monitoring throughout the test period, provide strong evidence that this is an acceptable method. 

     

     

     

     

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Assessment of Salt-sensitivity
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Coruzzi P, Brambilla L, Brambilla V, Gualerzi M, Rossi M, Parati G, Di Rienzo M, Tadonio J, Novarini A. Potassium depletion and salt sensitivity in essential hypertension. J Clin Endocrinol Metab. 2001 Jun; 86(6): 2,857-2,862.
      • de la Sierra A, Lluch MM, Coca A, Aguilera MT, Sánchez M, Sierra C, Urbano-Márquez A. Assessment of salt sensitivity in essential hypertension by 24-hour ambulatory blood pressure monitoring. Am J Hypertens. 1995 Oct; 8 (10 Pt 1): 970-977.
      • de la Sierra A, Giner V, Bragulat E, Coca A. Lack of correlation between two methods for the assessment of salt sensitivity in essential hypertension. J Hum Hypertens. 2002 Apr; 16(4): 255-260.
      • Galletti F, Ferrara I, Stinga F, Iacone R, Noviello F, Strazzullo P. Evaluation of a rapid protocol for the assessment of salt sensitivity against the blood pressure response to dietary sodium chloride restriction. Am J Hypertens. 1997 Apr; 10 (4 Pt 1): 462-466.
      • Gerdts E, Lund-Johansen P, Omvik P. Reproducibility of salt-sensitive testing using a dietary approach in essential hypertension. J Hum Hypertens. 1999; 13: 375-384.
      • Gerdts E, Myking OL, Omvik P. Salt sensitive essential hypertension evaluated by 24-hour ambulatory blood pressure. Blood Press. 1994 Nov; 3(6): 375-380.
      • Overlack A, Ruppert M, Kolloch R, et al. Divergent hemodynamic and hormonal response to varying salt intake in normotensive subjects. Hypertension. 1993; 22: 331-338.
      • Schmidlin O, Forman A, Sebastian A, Morris RC Jr. Sodium-selective salt sensitivity: its occurrence in blacks. Hypertension. 2007 Dec; 50 (6): 1,085-1,092. Epub. 2007 Oct. 15.
      • Sharma AM, Schattenfroh S, Kribben A, Distler A. Reliability of salt-sensitivity testing in normotensive subjects. Klin Wochenschr. 1989 Jun 15; 67(12): 632-634.
      • Strazzullo P, Galletti F, Dessi-Fulgheri P, Ferri C, Glorioso N, Malatino L, Mantero F, Manunta P, Semplicini A, Ghiadoni L, Zoccali, C. Prediction and consistency of blood pressure salt-sensitivity as assessed by a rapid volume expansion and contraction protocol. Journal of Nephrology. 2000 Jan-Feb; 13(1): 46-53.
      • Wedler B, Brier ME, Wiersbitzky M, Gruska S, Wolf E, Kallwellis R, Aronoff GR, Luft FC. Sodium kinetics in salt-sensitive and salt-resistant normotensive and hypertensive subjects. Journal of Hypertension. 1992 Jul; 10(7): 663-669.
      • Weinberger MH, Fineberg NS. Sodium and volume sensitivity of blood pressure: Age and pressure change over time. Hypertension. 1991; 18: 67-71.
      • Weinberger MH, Stegner JE, Fineberg NS. A comparison of two tests for the assessment of blood pressure responses to sodium. Am J Hypertens. 1993; 6: 179-184.
  • Search Plan and Results: NA: Salt Sensitivity Assessment 2009