Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia Syndrome
| Autor: | Luis E. Okamoto, André Diedrich, William D. Dupont, Cyndya A. Shibao, David Robertson, Jorge E Celedonio, Sachin Y. Paranjape, Bonnie K. Black, Victor C. Nwazue, Italo Biaggioni, Alfredo Gamboa, Satish R. Raj, Emily M. Garland |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Sodium Posture High sodium chemistry.chemical_element Blood Pressure 030204 cardiovascular system & hematology Article 03 medical and health sciences Norepinephrine Postural Orthostatic Tachycardia Syndrome Young Adult 0302 clinical medicine Plasma norepinephrine Heart Rate Internal medicine Hypovolemia Medicine Humans In patient 030212 general & internal medicine Sodium Chloride Dietary Cross-Over Studies business.industry Dietary sodium intake Sodium Dietary Middle Aged Postural tachycardia chemistry Cardiology Female Orthostatic tachycardia medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | J Am Coll Cardiol |
| ISSN: | 1558-3597 |
| Popis: | BACKGROUND: High sodium intake is recommended for the treatment of postural tachycardia syndrome (POTS) to counteract the hypovolemia and elevated plasma norepinephrine that contribute to excessive orthostatic tachycardia, but evidence of its efficacy is not available. OBJECTIVES: We tested whether a high sodium (HS) diet reduces orthostatic tachycardia (ΔHR) and upright heart rate (HR) compared with low sodium (LS) diet in POTS patients, and secondarily its effect on plasma volume (PV) and plasma norepinephrine. METHODS: We enrolled 14 POTS patients and 13 healthy controls (HC), 23–49 years old, in a crossover study with six days of LS (10 mEq sodium/day) or HS (300 mEq sodium/day) diet. We measured supine and standing HR, blood pressure, serum aldosterone, plasma renin activity, blood volume, and plasma norepinephrine and epinephrine. RESULTS: In POTS, HS diet reduced upright HR and ΔHR compared with LS diet. Total blood volume and PV increased, and standing norepinephrine decreased with HS compared with LS diet However, upright HR, ΔHR and upright norepinephrine remained higher in POTS than in HC on HS diet [117 (98–121) beats per minute (bpm), 46 (32–55) bpm, and 753 (498–919) pg/mL in POTS vs. 85 (77–95) bpm, 19 (11–32) bpm, and 387 (312–433) pg/mL in HC], despite no difference in the measured PV. CONCLUSIONS: In POTS patients, high dietary sodium intake compared with low dietary sodium intake increases plasma volume, lowers standing plasma norepinephrine, and decreases ΔHR. CONDENSED ABSTRACT: Postural Tachycardia Syndrome (POTS) is a chronic form of orthostatic intolerance. Augmented oral sodium intake is a frequently prescribed treatment and recommended in professional society scientific statements on POTS, but evidence supporting the effectiveness was lacking. We evaluated one week of a very high sodium diet compared to a very low sodium diet in POTS patients. The high sodium diet expanded the plasma volume and total blood volume, reduced standing plasma norepinephrine levels (a marker of sympathetic nervous system tone), and reduced the orthostatic tachycardia. These data provide supporting evidence for the use of high sodium diets in POTS patients. ClinicalTrials.gov Identifier: NCT01547117 |
| Databáze: | OpenAIRE |
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