Blood pressure and metabolic responses to moderate sodium restriction in isradipine-treated hypertensive patients

David A. McCarron, Alan B. Weder, Brent M. Egan, Gopal G. Krishna, Cynthia Morris, Michael Cohen, Suzanne Oparil

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

This multicenter, randomized, controlled clinical trial assessed the influence of sodium chloride intake on the antihypertensive effect of the calcium channel blocker isradipine. Participants with uncomplicated hypertension controlled by isradipine entered a 4-week sodium-restricted (60 to 80 mmol/24 h) period. Participants with urinary sodium levels <120 mmol/24 h (n = 99) were randomized to placebo or sodium chloride (100 mmol/24 h) for 4 weeks, and then crossed over to the alternative treatment for an additional 4 weeks. Mean baseline systolic blood pressure was 151.9 ± 16.7 mm Hg (mean ± SD). During open-label isradipine treatment, systolic blood pressures for ad libitum sodium chloride and restriction were 134.1 ± 11.1 and 132.1 ± 12.2 mm Hg respectively; for double-blind sodium chloride restriction and supplementation: 133.6 ± 12.6 and 138.5 ± 12.8 mm Hg (P <.01). Urinary sodium excretion values for open-label isradipine ad libitum versus restricted were 140.6 ± 61.9 versus 76.9 ± 32.4 mmol/24 h; for double-blind restricted versus supplemented, sodium excretion was 120.5 ± 68.9 v 175.9 ± 68.7 mmol/24 h (P ≤ .0001). Changes in urinary sodium excretion were not predictive of variations in blood pressure. Urinary sodium excretion during sodium restriction correlated directly with HDL-cholesterol (P <.02) and inversely with total cholesterol:HDL-cholesterol (P = .02), despite decreased total and saturated fat intake (P <.01). Sodium restriction was associated with significant reductions (P <.01) in virtually all macronutrients and electrolytes, and thus had an adverse impact on overall nutrition. The antihypertensive action of isradipine was not enhanced by dietary sodium chloride restriction, and the lipoprotein proble was least favorable with sodium chloride restriction.

Original languageEnglish (US)
Pages (from-to)68-76
Number of pages9
JournalAmerican Journal of Hypertension
Volume10
Issue number1
DOIs
StatePublished - Jan 1997

Fingerprint

Isradipine
Sodium
Blood Pressure
Sodium Chloride
HDL Cholesterol
Antihypertensive Agents
Dietary Sodium Chloride
Calcium Channel Blockers
Electrolytes
Lipoproteins
Randomized Controlled Trials
Fats
Cholesterol
Placebos
Hypertension

Keywords

  • antihyperetensive medications
  • blood pressure
  • calcium channel blockers
  • hypertension
  • lipids
  • sodium restriction
  • sodium-dietary

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Blood pressure and metabolic responses to moderate sodium restriction in isradipine-treated hypertensive patients. / McCarron, David A.; Weder, Alan B.; Egan, Brent M.; Krishna, Gopal G.; Morris, Cynthia; Cohen, Michael; Oparil, Suzanne.

In: American Journal of Hypertension, Vol. 10, No. 1, 01.1997, p. 68-76.

Research output: Contribution to journalArticle

McCarron, David A. ; Weder, Alan B. ; Egan, Brent M. ; Krishna, Gopal G. ; Morris, Cynthia ; Cohen, Michael ; Oparil, Suzanne. / Blood pressure and metabolic responses to moderate sodium restriction in isradipine-treated hypertensive patients. In: American Journal of Hypertension. 1997 ; Vol. 10, No. 1. pp. 68-76.
@article{092c6e42d6ba4e59aaa8f2958ab3ff8a,
title = "Blood pressure and metabolic responses to moderate sodium restriction in isradipine-treated hypertensive patients",
abstract = "This multicenter, randomized, controlled clinical trial assessed the influence of sodium chloride intake on the antihypertensive effect of the calcium channel blocker isradipine. Participants with uncomplicated hypertension controlled by isradipine entered a 4-week sodium-restricted (60 to 80 mmol/24 h) period. Participants with urinary sodium levels <120 mmol/24 h (n = 99) were randomized to placebo or sodium chloride (100 mmol/24 h) for 4 weeks, and then crossed over to the alternative treatment for an additional 4 weeks. Mean baseline systolic blood pressure was 151.9 ± 16.7 mm Hg (mean ± SD). During open-label isradipine treatment, systolic blood pressures for ad libitum sodium chloride and restriction were 134.1 ± 11.1 and 132.1 ± 12.2 mm Hg respectively; for double-blind sodium chloride restriction and supplementation: 133.6 ± 12.6 and 138.5 ± 12.8 mm Hg (P <.01). Urinary sodium excretion values for open-label isradipine ad libitum versus restricted were 140.6 ± 61.9 versus 76.9 ± 32.4 mmol/24 h; for double-blind restricted versus supplemented, sodium excretion was 120.5 ± 68.9 v 175.9 ± 68.7 mmol/24 h (P ≤ .0001). Changes in urinary sodium excretion were not predictive of variations in blood pressure. Urinary sodium excretion during sodium restriction correlated directly with HDL-cholesterol (P <.02) and inversely with total cholesterol:HDL-cholesterol (P = .02), despite decreased total and saturated fat intake (P <.01). Sodium restriction was associated with significant reductions (P <.01) in virtually all macronutrients and electrolytes, and thus had an adverse impact on overall nutrition. The antihypertensive action of isradipine was not enhanced by dietary sodium chloride restriction, and the lipoprotein proble was least favorable with sodium chloride restriction.",
keywords = "antihyperetensive medications, blood pressure, calcium channel blockers, hypertension, lipids, sodium restriction, sodium-dietary",
author = "McCarron, {David A.} and Weder, {Alan B.} and Egan, {Brent M.} and Krishna, {Gopal G.} and Cynthia Morris and Michael Cohen and Suzanne Oparil",
year = "1997",
month = "1",
doi = "10.1016/S0895-7061(96)00295-6",
language = "English (US)",
volume = "10",
pages = "68--76",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Blood pressure and metabolic responses to moderate sodium restriction in isradipine-treated hypertensive patients

AU - McCarron, David A.

AU - Weder, Alan B.

AU - Egan, Brent M.

AU - Krishna, Gopal G.

AU - Morris, Cynthia

AU - Cohen, Michael

AU - Oparil, Suzanne

PY - 1997/1

Y1 - 1997/1

N2 - This multicenter, randomized, controlled clinical trial assessed the influence of sodium chloride intake on the antihypertensive effect of the calcium channel blocker isradipine. Participants with uncomplicated hypertension controlled by isradipine entered a 4-week sodium-restricted (60 to 80 mmol/24 h) period. Participants with urinary sodium levels <120 mmol/24 h (n = 99) were randomized to placebo or sodium chloride (100 mmol/24 h) for 4 weeks, and then crossed over to the alternative treatment for an additional 4 weeks. Mean baseline systolic blood pressure was 151.9 ± 16.7 mm Hg (mean ± SD). During open-label isradipine treatment, systolic blood pressures for ad libitum sodium chloride and restriction were 134.1 ± 11.1 and 132.1 ± 12.2 mm Hg respectively; for double-blind sodium chloride restriction and supplementation: 133.6 ± 12.6 and 138.5 ± 12.8 mm Hg (P <.01). Urinary sodium excretion values for open-label isradipine ad libitum versus restricted were 140.6 ± 61.9 versus 76.9 ± 32.4 mmol/24 h; for double-blind restricted versus supplemented, sodium excretion was 120.5 ± 68.9 v 175.9 ± 68.7 mmol/24 h (P ≤ .0001). Changes in urinary sodium excretion were not predictive of variations in blood pressure. Urinary sodium excretion during sodium restriction correlated directly with HDL-cholesterol (P <.02) and inversely with total cholesterol:HDL-cholesterol (P = .02), despite decreased total and saturated fat intake (P <.01). Sodium restriction was associated with significant reductions (P <.01) in virtually all macronutrients and electrolytes, and thus had an adverse impact on overall nutrition. The antihypertensive action of isradipine was not enhanced by dietary sodium chloride restriction, and the lipoprotein proble was least favorable with sodium chloride restriction.

AB - This multicenter, randomized, controlled clinical trial assessed the influence of sodium chloride intake on the antihypertensive effect of the calcium channel blocker isradipine. Participants with uncomplicated hypertension controlled by isradipine entered a 4-week sodium-restricted (60 to 80 mmol/24 h) period. Participants with urinary sodium levels <120 mmol/24 h (n = 99) were randomized to placebo or sodium chloride (100 mmol/24 h) for 4 weeks, and then crossed over to the alternative treatment for an additional 4 weeks. Mean baseline systolic blood pressure was 151.9 ± 16.7 mm Hg (mean ± SD). During open-label isradipine treatment, systolic blood pressures for ad libitum sodium chloride and restriction were 134.1 ± 11.1 and 132.1 ± 12.2 mm Hg respectively; for double-blind sodium chloride restriction and supplementation: 133.6 ± 12.6 and 138.5 ± 12.8 mm Hg (P <.01). Urinary sodium excretion values for open-label isradipine ad libitum versus restricted were 140.6 ± 61.9 versus 76.9 ± 32.4 mmol/24 h; for double-blind restricted versus supplemented, sodium excretion was 120.5 ± 68.9 v 175.9 ± 68.7 mmol/24 h (P ≤ .0001). Changes in urinary sodium excretion were not predictive of variations in blood pressure. Urinary sodium excretion during sodium restriction correlated directly with HDL-cholesterol (P <.02) and inversely with total cholesterol:HDL-cholesterol (P = .02), despite decreased total and saturated fat intake (P <.01). Sodium restriction was associated with significant reductions (P <.01) in virtually all macronutrients and electrolytes, and thus had an adverse impact on overall nutrition. The antihypertensive action of isradipine was not enhanced by dietary sodium chloride restriction, and the lipoprotein proble was least favorable with sodium chloride restriction.

KW - antihyperetensive medications

KW - blood pressure

KW - calcium channel blockers

KW - hypertension

KW - lipids

KW - sodium restriction

KW - sodium-dietary

UR - http://www.scopus.com/inward/record.url?scp=0031016032&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031016032&partnerID=8YFLogxK

U2 - 10.1016/S0895-7061(96)00295-6

DO - 10.1016/S0895-7061(96)00295-6

M3 - Article

C2 - 9008250

AN - SCOPUS:0031016032

VL - 10

SP - 68

EP - 76

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 1

ER -