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Pressure-Natriuresis Response Is Diminished in Old Age
Yang Gyun Kim1, Ju-Young Moon1, Bermseok Oh2
1Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
Frontiers in Cardiovascular Medicine
|March 7, 2022
Summary
Older adults have a weakened pressure-natriuresis response, impacting blood pressure regulation. This age-related decline in kidney sodium handling contributes to elevated blood pressure in aging populations.
Area of Science:
- Nephrology
- Gerontology
- Cardiovascular Research
Background:
- Aging is associated with altered renal sodium handling, influencing blood pressure (BP).
- The relationship between age, kidney function, and BP regulation requires further clarification.
Purpose of the Study:
- To investigate age-related changes in the pressure-natriuresis response.
- To determine if a diminished pressure-natriuresis response contributes to elevated BP in older individuals.
Main Methods:
- Analysis of 4,859 participants (Korean Genome and Epidemiology Study) and 235 patients (ESPECIAL trial) divided into younger and older groups.
- In the ESPECIAL trial, participants received olmesartan and a low-salt diet (LSD).
- Assessment of estimated glomerular filtration rate (eGFR), urine sodium, albuminuria, and BP.
Main Results:
- Older participants exhibited lower eGFR, urine concentration, and higher albuminuria.
- Older individuals had higher BP and lower urine sodium in the KoGES study.
- Olmesartan reduced BP in all groups; LSD lowered systolic BP only in older participants.
- The pressure-natriuresis response, indicated by urine sodium changes, was blunted in older individuals.
Conclusions:
- The pressure-natriuresis response is diminished in older individuals.
- This age-related decline in renal sodium handling may contribute to hypertension in the elderly.
- Understanding these changes is crucial for managing BP in aging populations.
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