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THE RESPONSE TO THE ADMINISTRATION OF AN ISOTONIC SODIUM CHLORIDE-LACTATE SOLUTION IN PATIENTS WITH ESSENTIAL HYPERTENSION

1960; American Society for Clinical Investigation; Volume: 39; Issue: 6 Linguagem: Inglês

10.1172/jci104108

1558-8238

Solomon Papper, Joseph L. Belsky, Kenneth H. Bleifer,

Pharmacological Effects of Natural Compounds

Many studies indicate that patients with es- sential hypertension have a greater natriuretic re- sponse to rapidly administered sodium chloride solutions than have normotensive individuals (1-7).However, in most instances other fac- tors known to influence the rate of sodium ex- cretion in the normal subject such as diet, pos- ture, and time of day have not been rigidly con- trolled (8, 9).Dietary control is of particular importance in view of observations suggesting that patients with hypertension may habitually ingest more salt than do normotensive individuals (10-11).If this is indeed the case it might well be responsible for the enhanced response of the hypertensive patient to administered salt.The present report is concerned with a com- parison of the response of hypertensive and nor- motensive individuals to the intravenous administration of an "isotonic-balanced" salt solution under rigidly controlled conditions and at three dif- ferent levels of dietary salt ingestion.The re- sults indicate that patients with essential hypertension excrete the infused sodium load more rapidly than do normotensive individuals at each level of salt consumption. METHODSFour niormal Caucasian males aged 29 to 36 and 6 Caucasian patients aged 24 to 63 with essential hypertension were studied.The patients were selected on the basis of their maintaining a resting diastolic blood pres- sure of at least 100 mm Hg while hospitalized and con- suming a diet containing approximately 10 mEq of so- dium daily.Five of the 6 subjects were observed in this manner for 13 to 47 days prior to study, while Patient 8 received the low salt diet for 8 days prior to study.No patient had congestive heart failure, although no. 5 had