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Altered renal sodium handling and risk of incident hypertension : results of the Olivetti Heart Study
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D’Elia, Lanfranco, Cappuccio, Francesco, Iacone, Roberto, Russo, Ornella, Galletti, Ferruccio and Strazzullo, Pasquale (2017) Altered renal sodium handling and risk of incident hypertension : results of the Olivetti Heart Study. PLoS One, 12 (2). e0171973. doi:10.1371/journal.pone.0171973 ISSN 1932-6203.
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Official URL: http://dx.doi.org/10.1371/journal.pone.0171973
Abstract
Renal tubular sodium (Na) handling plays a key role in blood pressure (BP) regulation. Several cross-sectional studies reported a positive association between higher proximal tubule fractional reabsorption of Na and BP, but no prospective investigation has been reported of this possible association. Hence, the purpose of this study was to estimate the predictive role of renal Na handling on the risk of incident hypertension and the changes in BP occurring in the 8-year follow-up observation of a sample of initially normotensive men (The Olivetti Heart Study). The study included 294 untreated normotensive non-diabetic men with normal renal function examined twice (1994–95 and 2002–04). Renal tubular Na handling was estimated by exogenous lithium clearance. Fractional reabsorption of Na in proximal and distal tubules was calculated and included in the analysis. At baseline, there was no association between BP and either proximal or distal fractional reabsorption of Na. At the end of the 8-year follow-up, direct associations were observed between baseline proximal (but not distal) Na fractional reabsorption and the changes occurred in systolic and diastolic BP over time (+2.79 and +1.53 mmHg, respectively, per 1SD difference in proximal Na-FR; p<0.01). Also multivariable analysis showed a direct association between baseline proximal Na fractional reabsorption and risk of incident hypertension, independently of potential confounders (OR: 1.34, 95%CI:1.06–1.70). The results of this prospective investigation strongly suggest a causal relationship between an enhanced rate of Na reabsorption in the proximal tubule and the risk of incident hypertension in initially normotensive men.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
| Library of Congress Subject Headings (LCSH): | Hypertension -- Risk factors, Hypertension -- Physiology, Diabetics -- Testing, Men -- Diseases -- Treatment | ||||||||
| Journal or Publication Title: | PLoS One | ||||||||
| Publisher: | Public Library of Science | ||||||||
| ISSN: | 1932-6203 | ||||||||
| Official Date: | 2017 | ||||||||
| Dates: |
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| Volume: | 12 | ||||||||
| Number: | 2 | ||||||||
| Article Number: | e0171973 | ||||||||
| DOI: | 10.1371/journal.pone.0171973 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 21 February 2017 | ||||||||
| Date of first compliant Open Access: | 21 February 2017 | ||||||||
| Adapted As: |
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