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Efectos neuroadrenérgicos a corto y largo plazo de la restricción moderada de sodio en la dieta en la hipertensión
Guido Grassi1, Raffaella Dell'Oro, Gino Seravalle
1Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Centro Interuniversitario di Fisiologia Clinica e Ipertensione and Istituto Auxologico Italiano, Milan, Italy.
Circulation
|October 9, 2002
Resumen
La restricción moderada de sodio en la hipertensión esencial aumenta la actividad nerviosa simpática y perjudica la función barorrefleja. Estos efectos adversos persisten con las dietas bajas en sodio a largo plazo, destacando los riesgos de la reducción de sodio en la dieta.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Investigación de la Hipertensión Investigación de la Hipertensión
- La neuroendocrinología en neuroendocrinología.
Sus antecedentes:
- La hipertensión esencial a menudo se asocia con la desregulación del sistema nervioso simpático.
- La restricción severa de sodio a corto plazo puede aumentar agudamente el tráfico del nervio simpático muscular (MSNA) y deteriorar los barorreflejos.
Objetivo del estudio:
- Investigar los efectos neuroadrenérgicos y reflejos a largo plazo de la restricción moderada de sodio en la dieta en pacientes con hipertensión esencial.
Principales métodos:
- 11 pacientes con hipertensión esencial de leve a moderada se sometieron a mediciones de la presión arterial, la frecuencia cardíaca y la ANSM.
- Las mediciones se tomaron durante la ingesta regular de sodio, después de 1 semana de dieta baja en sodio (80 mmol NaCl / d) y después de 8 semanas de la misma dieta.
Principales resultados:
- Una semana de dieta baja en sodio aumentó la actividad plasmática de renina, aldosterona y MSNA en un 23%, mientras que redujo la modulación de barorreflejo de MSNA en un 47%.
- Estos cambios neurohumorales y de barorreflejo persistieron a las 8 semanas y se normalizaron al volver a una dieta regular de sodio.
Conclusiones:
- La restricción moderada de sodio en la dieta induce la activación simpática y el deterioro del barorreflejo en la hipertensión esencial.
- Una dieta baja en sodio sostenida durante varias semanas no mitiga estas alteraciones neuroadrenérgicas y reflejas perjudiciales.
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