AUTHOR=Zhou Lihua , Jiang Yiran , Zhang Cui , Su Tingwei , Jiang Lei , Zhou Weiwei , Zhong Xu , Wu Luming , Wang Weiqing 

TITLE=Effects of a low-sodium diet in patients with idiopathic hyperaldosteronism: a randomized controlled trial

JOURNAL=Frontiers in Endocrinology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1124479

DOI=10.3389/fendo.2023.1124479

ISSN=1664-2392

ABSTRACT=<sec><title>Background</title><p>Idiopathic hyperaldosteronism (IHA) is one of the most common types of primary aldosteronism (PA), an important cause of hypertension. Although high dietary sodium is a major risk factor for hypertension, there is no consensus on the recommended dietary sodium intake for IHA.</p></sec><sec><title>Objective</title><p>This study investigated the effect of a low-sodium diet on hemodynamic variables and relevant disease biomarkers in IHA patients, with the aim of providing a useful reference for clinical treatment.</p></sec><sec><title>Methods</title><p>Fifty IHA patients were evenly randomized into two groups and provided, after a 7-day run-in period (100 mmol/d sodium), either a low-sodium diet (50 mmol/d sodium) or a normal sodium diet (100 mmol/d sodium) for an additional 7 days. After the 14-day intervention (conducted without potassium supplementation), changes in blood pressure (BP) and serum potassium were evaluated in both groups.</p></sec><sec><title>Results</title><p>After the dietary intervention, the low sodium group exhibited, compared to the normal sodium group, decreased BP (SBP: 121.8 ± 12.8 <italic>vs</italic>. 129.9 ± 12.1 mmHg, p &lt; 0.05; DBP: 82.6 ± 7.6 <italic>vs</italic>. 86.4 ± 8.2 mmHg, p &lt; 0.05; MAP: 95.7 ± 8.8 <italic>vs</italic>. 100.9 ± 8.4 mmHg, p &lt; 0.05) and increased serum potassium levels (3.38 ± 0.33 <italic>vs</italic>. 3.07 ± 0.27 mmol/L, p &lt; 0.001). The low sodium group showed also better control of both BP and serum potassium: BP &lt;140/90 mmHg in 70.0% of total patients (76.0% <italic>vs</italic>. 64.0%, in the low and normal sodium groups, respectively; p &gt; 0.05), BP &lt;130/85 mmHg in 38.0% of total patients (56.0% <italic>vs</italic>. 20.0%, p &lt; 0.05), BP &lt;120/80 mmHg in 28.0% of total patients (44.0% <italic>vs</italic>. 12.0%, p &lt; 0.05); serum potassium ≥3.5 mmol/L in 22.0% of total patients (32.0% <italic>vs</italic>. 12.0% in the low and normal sodium groups, respectively; p = 0.088). There were differences between the controlled BP group (&lt;120/80 mmHg) and the non-controlled BP group (≥120/80 mmHg) in gender, BP at baseline, and type of diet (low <italic>vs</italic>. normal sodium). Female gender and low-sodium diet were protective factors for BP control.</p></sec><sec><title>Conclusions</title><p>A low-sodium diet is effective in lowering BP and elevating serum potassium in IHA patients. Female patients on a low-sodium diet are more likely to achieve BP control (&lt;120/80 mmHg). We advocate a dietary sodium intake of 50 mmol/d for IHA patients.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov</ext-link>, Identifier NCT05649631.</p></sec>