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[The role of sodium and potassium in borderline hypertension].

To clarify the role of sodium and potassium in borderline hypertension, hemodynamic and endocrine studies were performed in 23 patients with borderline hypertension and 21 normotensives. Eleven of 23 patients with borderline hypertension, and nine of 21 normotensives received NaCI load (180 mEq/day) in combination with KC1 supplement (96 mEq /day) for 7 days after treatment with diuretics (Mefruside 25 mg/day for 7 days), whereas the other 1 of patients with borderline hypertension and 12 of normotensives had NaCI load without KCl supplement for 7 days after diuretics. The results were as follows. (1) The young borderline hypertensives had significantly higher cardiac output, heart rate and mean velocity of circumferential fiber shortening (hyperkinetic circulatory state) as compared to age-matched normotensives. Moreover, the former had higher plasma renin activity, plasma norepinephrine concentration and plasma epinephrine concentration than the latter, It is suggested that an increased adreno-sympathetic activity may contribute to the hyperkinetic circulatory state in young adults with borderline hypertension. (2) Whereas blood pressure remained unchanged with diuretics and salt loading in normotensives, blood pressure and cardiac output significantly decreased with diuretics in borderline hypertensives, and both parameters significantly increased by salt loading. It is suggested that the changes in blood pressure with diuretics and salt loading in borderline hypertensives are associated with those in cardiac output. (3) In the young borderline hypertensives, the elevation of blood pressure due to salt loading was inhibited by KCl supplement, possibly because of suppression of increased cardiac output. Although the mechanisms of the pressor action of sodium and the depressor action of potassium are still unknown, the evidences presented suggest that adreno-sympathetic nervous system may participate partially in the changes in blood pressure due to alterations of sodium and potassium balance in borderline hypertension.