PMID- 22865897
OWN - NLM
STAT- MEDLINE
DCOM- 20121218
LR  - 20211021
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 97
IP  - 10
DP  - 2012 Oct
TI  - Nonmodulation as the mechanism for salt sensitivity of blood pressure in 
      individuals with hypertension and type 2 diabetes mellitus.
PG  - 3775-82
LID - 10.1210/jc.2012-2127 [doi]
AB  - CONTEXT: It is assumed that in individuals with type 2 diabetes mellitus (T2DM), 
      blood pressure sensitivity to salt intake and the frequency of a low renin state 
      are both increased compared with the nondiabetic population. However, studies 
      supporting these assumptions may have been confounded by participant inclusion 
      criteria, and study results may reflect target organ damage. OBJECTIVE: The 
      objective of this study was to examine in a cohort of T2DM 1) the frequency of 
      salt sensitivity of blood pressure and 2) whether alterations of the 
      renin-angiotensin-aldosterone system (RAAS) contribute to salt sensitivity in 
      this population. DESIGN, PATIENTS, AND METHODS: Within participants of the 
      HyperPATH cohort, four groups were analyzed: 1) T2DM with hypertension (HTN), 
      n=51; 2) T2DM without HTN, n=30; 3) HTN only, n=451; and 4) normotensive, n=209. 
      Phenotype studies were conducted after participants completed two dietary phases: 
      liberal sodium (200 mmol/d) and low sodium (10 mmol/d) for 7 d each. Participants 
      were admitted overnight to a clinical research center after each diet, and supine 
      measurements of the RAAS before and after a 60-min angiotensin II infusion (3 
      ng/kg.min) were obtained. RESULTS: Multivariate regression analysis demonstrated 
      that T2DM status (all individuals with T2DM vs. individuals without T2DM) was not 
      associated with the change in mean arterial pressure between the low and liberal 
      sodium diets after accounting for age, gender, body mass index, race, and 
      baseline blood pressure (T2DM status, P=0.5). Furthermore, two intermediate 
      phenotypes of altered RAAS, low renin, and nonmodulation (NMOD), were associated 
      with salt-sensitive blood pressure but occurred at different frequencies in the 
      T2DM-HTN and HTN groups (low renin, 12% T2DM-HTN vs. 29% HTN; NMOD, 41% T2DM-HTN 
      vs. 27% HTN; P=0.01). CONCLUSION: The frequency of NMOD in participants with T2DM 
      was significantly higher compared with HTN, suggesting that the salt sensitivity 
      often seen in T2DM is driven by NMOD.
FAU - Underwood, Patricia C
AU  - Underwood PC
AD  - Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's 
      Hospital, Harvard Medical School, 221 Longwood Avenue, RFB 386, Boston, 
      Massachusetts 02115, USA. punderwood1@partners.org
FAU - Chamarthi, Bindu
AU  - Chamarthi B
FAU - Williams, Jonathan S
AU  - Williams JS
FAU - Vaidya, Anand
AU  - Vaidya A
FAU - Garg, Rajesh
AU  - Garg R
FAU - Adler, Gail K
AU  - Adler GK
FAU - Grotzke, Marissa P
AU  - Grotzke MP
FAU - Staskus, Gitana
AU  - Staskus G
FAU - Wadwekar, Devendra
AU  - Wadwekar D
FAU - Hopkins, Paul N
AU  - Hopkins PN
FAU - Ferri, Claudio
AU  - Ferri C
FAU - McCall, Anthony
AU  - McCall A
FAU - McClain, Donald
AU  - McClain D
FAU - Williams, Gordon H
AU  - Williams GH
LA  - eng
GR  - R01 HL047651/HL/NHLBI NIH HHS/United States
GR  - K23 HL084236/HL/NHLBI NIH HHS/United States
GR  - M01-RR02635/RR/NCRR NIH HHS/United States
GR  - UL1RR025758/RR/NCRR NIH HHS/United States
GR  - T32 HL007609/HL/NHLBI NIH HHS/United States
GR  - U54 LM008748/LM/NLM NIH HHS/United States
GR  - T32HL007609/HL/NHLBI NIH HHS/United States
GR  - U54LM008748/LM/NLM NIH HHS/United States
GR  - UL1 RR025758/RR/NCRR NIH HHS/United States
GR  - K23 HL111771/HL/NHLBI NIH HHS/United States
GR  - F32 NR013318/NR/NINR NIH HHS/United States
GR  - HL59424/HL/NHLBI NIH HHS/United States
GR  - P50 HL055000/HL/NHLBI NIH HHS/United States
GR  - M01 RR002635/RR/NCRR NIH HHS/United States
GR  - P50HL055000/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20120803
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Sodium Chloride, Dietary)
RN  - EC 3.4.23.15 (Renin)
SB  - IM
MH  - Adult
MH  - Blood Pressure/*physiology
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/epidemiology/*metabolism
MH  - Diet, Sodium-Restricted
MH  - Female
MH  - Humans
MH  - Hypertension, Renal/epidemiology/*metabolism
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Renin/metabolism
MH  - Renin-Angiotensin System/*physiology
MH  - Risk Factors
MH  - Sodium Chloride, Dietary/*administration & dosage
PMC - PMC3462947
EDAT- 2012/08/07 06:00
MHDA- 2012/12/19 06:00
PMCR- 2013/10/01
CRDT- 2012/08/07 06:00
PHST- 2012/08/07 06:00 [entrez]
PHST- 2012/08/07 06:00 [pubmed]
PHST- 2012/12/19 06:00 [medline]
PHST- 2013/10/01 00:00 [pmc-release]
AID - jc.2012-2127 [pii]
AID - 12-2127 [pii]
AID - 10.1210/jc.2012-2127 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2012 Oct;97(10):3775-82. doi: 10.1210/jc.2012-2127. Epub 
      2012 Aug 3.