Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10845
Title: Effects of salt supplementation on the albuminuric response to telmisartan with or without hydrochlorothiazide therapy in hypertensive patients with type 2 diabetes are modulated by habitual dietary salt intake.
Authors: Ekinci, Elif I;Thomas, Georgina;Thomas, David;Johnson, Cameron;Macisaac, Richard J;Houlihan, Christine A;Finch, Sue;Panagiotopoulos, Sianna;O'Callaghan, Christopher J;Jerums, George
Affiliation: Endocrine Centre, Austin Health and University of Melbourne, Heidelberg Repatriation Hospital, Heidelberg West, Victoria, Australia. eekinci2002@yahoo.com.au
Issue Date: 23-Jun-2009
Citation: Diabetes Care 2009; 32(8): 1398-403
Abstract: OBJECTIVE This prospective randomized double-blind placebo-controlled crossover study examined the effects of sodium chloride (NaCl) supplementation on the antialbuminuric action of telmisartan with or without hydrochlorothiazide (HCT) in hypertensive patients with type 2 diabetes, increased albumin excretion rate (AER), and habitual low dietary salt intake (LDS; <100 mmol sodium/24 h on two of three consecutive occasions) or high dietary salt intake (HDS; >200 mmol sodium/24 h on two of three consecutive occasions). RESEARCH DESIGN AND METHODS Following a washout period, subjects (n = 32) received 40 mg/day telmisartan for 4 weeks followed by 40 mg telmisartan plus 12.5 mg/day HCT for 4 weeks. For the last 2 weeks of each treatment period, patients received either 100 mmol/day NaCl or placebo capsules. After a second washout, the regimen was repeated with supplements in reverse order. AER and ambulatory blood pressure were measured at weeks 0, 4, 8, 14, 18, and 22. RESULTS In LDS, NaCl supplementation reduced the anti-albuminuric effect of telmisartan with or without HCT from 42.3% (placebo) to 9.5% (P = 0.004). By contrast, in HDS, NaCl supplementation did not reduce the AER response to telmisartan with or without HCT (placebo 30.9%, NaCl 28.1%, P = 0.7). Changes in AER were independent of changes in blood pressure. CONCLUSIONS The AER response to telmisartan with or without HCT under habitual low salt intake can be blunted by NaCl supplementation. By contrast, when there is already a suppressed renin angiotensin aldosterone system under habitual high dietary salt intake, the additional NaCl does not alter the AER response.
Internal ID Number: 19549737
URI: http://ahro.austin.org.au/austinjspui/handle/1/10845
DOI: 10.2337/dc08-2297
ORCID: 0000-0002-0845-0001
URL: http://www.ncbi.nlm.nih.gov/pubmed/19549737
Type: Journal Article
Subjects: Aged
Albuminuria.drug therapy.physiopathology
Angiotensin-Converting Enzyme Inhibitors.therapeutic use
Antihypertensive Agents.therapeutic use
Benzimidazoles.therapeutic use
Benzoates.therapeutic use
Blood Pressure.drug effects.physiology
Cross-Over Studies
Diabetes Mellitus, Type 2.complications
Dietary Supplements
Female
Glomerular Filtration Rate.drug effects
Humans
Hydrochlorothiazide.therapeutic use
Hypertension.drug therapy
Male
Middle Aged
Sodium Chloride.administration & dosage.therapeutic use
Sodium, Dietary
Appears in Collections:Journal articles

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