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Publication
Effect of High Dietary Sodium Intake in Patients With Postural Tachycardia
Syndrome.
Authors Garland EM, Gamboa A, Nwazue VC, Celedonio JE, Paranjape SY, Black BK, Okamoto
LE, Shibao CA, Biaggioni I, Robertson D, Diedrich A, Dupont WD, Raj SR
Submitted By Submitted Externally on 12/3/2021
Status Published
Journal Journal of the American College of Cardiology
Year 2021
Date Published 5/1/2021
Volume : Pages 77 : 2174 - 2184
PubMed Reference 33926653
Abstract High sodium intake is recommended for the treatment of postural tachycardia
syndrome (POTS) to counteract the hypovolemia and elevated plasma norepinephrine
that contribute to excessive orthostatic tachycardia, but evidence of its
efficacy is not available., This study tested whether a high sodium (HS) diet
reduces orthostatic tachycardia (? heart rate) and upright heart rate compared
with a low sodium (LS) diet in POTS patients, and secondarily its effect on
plasma volume (PV) and plasma norepinephrine., A total of 14 POTS patients and
13 healthy control subjects (HC), age 23 to 49 years, were enrolled in a
crossover study with 6 days of LS (10 mEq sodium/day) or HS (300 mEq sodium/day)
diet. Supine and standing heart rate, blood pressure, serum aldosterone, plasma
renin activity, blood volume, and plasma norepinephrine and epinephrine were
measured., In POTS, the HS diet reduced upright heart rate and ? heart rate
compared with the LS diet. Total blood volume and PV increased, and standing
norepinephrine decreased with the HS compared with the LS diet. However, upright
heart rate, ? heart rate, and upright norepinephrine remained higher in POTS
than in HC on the HS diet (median 117 beats/min [interquartile range: 98 to 121
beats/min], 46 beats/min [interquartile range: 32 to 55 beats/min], and 753
pg/ml [interquartile range: 498 to 919 pg/ml] in POTS vs. 85 beats/min
[interquartile range: 77 to 95 beats/min], 19 beats/min [interquartile range: 11
to 32 beats/min], and 387 pg/ml [interquartile range: 312 to 433 pg/ml] in HC,
respectively), despite no difference in the measured PV., In POTS patients, high
dietary sodium intake compared with low dietary sodium intake increases plasma
volume, lowers standing plasma norepinephrine, and decreases ? heart rate.
(Dietary Salt in Postural Tachycardia Syndrome; NCT01547117).




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