Effects of salt loading and potassium supplement on the circadian blood pressure profile in salt-sensitive Chinese patients

• Published in: Blood pressure monitoring Vol. 22; no. 6; p. 307
• Main Authors: Guo, Tong-Shuai, Dai, Yi, Ren, Ke-Yu, Mu, Jian-Jun, Ren, Jie, Wang, Dan, Wang, Yang, Chu, Chao, Li, Yan, Yuan, Zu-Yi
• Format: Journal Article
• Language: English
• Published: England 01.12.2017
• Subjects: Adult; Asian Continental Ancestry Group; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory; Circadian Rhythm - drug effects; Diet, Sodium-Restricted; Dietary Supplements; Female; Humans; Hypertension - physiopathology; Male; Middle Aged; Potassium - administration & dosage; Sodium Chloride, Dietary - administration & dosage
• ISSN: 1473-5725
• DOI: 10.1097/MBP.0000000000000276

Salt-sensitive (SS) patients more frequently showed a nondipper blood pressure pattern and were associated with more serious target organ damage than non-SS patients. We aimed to investigate whether potassium supplement can improve the blunted nocturnal blood pressure fall in SS patients exposed to a high-salt diet. Approximately 49 normotensive and mildly hypertensive Chinese patients received a study protocol of a 3 days of baseline examination, 7 days of a low-salt diet (3 g NaCl/day), 7 days of a high-salt diet (18 g NaCl/day), and 7 days of a high-salt diet with a potassium supplement (18 g NaCl and 4.5 g KCl/day). The 24 h ambulatory blood pressure was determined at the end of each period. A total of 14 patients were classified as SS according to the at least 10% increase in their 24-h mean arterial pressure after high-salt loading. The night-to-day blood pressure ratio was significantly higher in SS patients than in non-SS patients during the high-salt loading period (systolic 0.96±0.01 vs. 0.89±0.01, P<0.01; diastolic 0.96±0.01 vs. 0.92±0.01, P<0.05). Compared with the high-salt loading period, the night-to-day blood pressure ratio was significantly reversed by potassium supplement in SS patients (systolic 0.91±0.01 vs. 0.96±0.01, P<0.05; diastolic 0.91±0.01 vs. 0.96±0.01, P<0.05). Potassium supplement can improve the blunted nocturnal blood pressure fall in SS patients exposed to a high-salt diet, but the related mechanism needs to be studied further.