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Dietary sodium restriction improves vascular endothelial dysfunction in middle‐aged and older adults with moderately elevated systolic blood pressure

Sodium intake is inversely related to endothelium‐dependent dilation (EDD), a measure of vascular endothelial function/health, in middle‐aged and older adults (MA/O) with moderately elevated systolic blood pressure (SBP; 130–159 mmHg). We hypothesized that dietary sodium restriction (DSR) would improve EDD in this group. EDD, measured by brachial artery flow‐mediated dilation (FMD) and peak forearm blood flow to acetylcholine (FBFACh), were 91% and 108% higher following a 4 week low sodium (LS; 63±9 mmol/day) vs. normal sodium (NS; 134±12 mmol/day) diet (p≤0.05; randomized, cross‐over design; 5M/3F; 59±3 yrs), whereas endothelium‐independent dilation (dilation to nitric oxide [NO] donors) did not differ (p≥0.20). Following LS, oxidative stress was reduced (< ΔFMD with intravenous ascorbic acid and < vascular endothelial cell nitrotyrosine), tetrahydrobiopterin (BH4) bioavailability was increased (< ΔFMD with oral BH4) and NO bioavailability was increased (> ΔFBFACh with co‐infusion of L‐NMMA) vs. the NS condition (p<0.05). These differences remained after correcting for SBP. Other subject characteristics/dietary factors were not different between conditions. These results indicate that DSR improves EDD in MA/O with moderately elevated SBP by reducing oxidative stress and enhancing BH4 and NO bioavailability.