Advertisement

Ten days of high dietary sodium does not impair cerebral blood flow regulation in healthy adults

      Abstract

      High dietary sodium impairs cerebral blood flow regulation in rodents and is associated with increased stroke risk in humans. However, the effects of multiple days of high dietary sodium on cerebral blood flow regulation in humans is unknown. Therefore, the purpose of this study was to determine whether ten days of high dietary sodium impairs cerebral blood flow regulation. Ten participants (3F/7M; age: 30 ± 10 years; blood pressure (BP): 113 ± 8/62 ± 9 mmHg) participated in this randomized, cross-over design study. Participants were placed on 10-day diets that included either low- (1000 mg/d), medium- (2300 mg/d) or high- (7000 mg/d) sodium separated by ≥four weeks. Urinary sodium excretion, beat-to-beat BP (finger photoplethysmography), middle cerebral artery velocity (transcranial Doppler), and end-tidal carbon dioxide (capnography) was measured. Dynamic cerebral autoregulation during a ten-minute baseline was calculated and cerebrovascular reactivity assessed by determining the percent change in middle cerebral artery blood flow velocity to hypercapnia (8% CO2, 21% oxygen, balance nitrogen) and hypocapnia (via mild hyperventilation). Urinary sodium excretion increased in a stepwise manner (ANOVA P = 0.001) from the low, to medium, to high condition. There were no differences in dynamic cerebral autoregulation between conditions. While there was a trend for a difference during cerebrovascular reactivity to hypercapnia (ANOVA P = 0.06), this trend was abolished when calculating cerebrovascular conductance (ANOVA: P = 0.28). There were no differences in cerebrovascular reactivity (ANOVA P = 0.57) or conductance (ANOVA: P = 0.73) during hypocapnia. These data suggest that ten days of a high sodium diet does not impair cerebral blood flow regulation in healthy adults.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Autonomic Neuroscience: Basic and Clinical
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ainslie P.N.
        • Murrell C.
        • Peebles K.
        • Swart M.
        • Skinner M.A.
        • Williams M.J.A.
        • Taylor R.D.
        Early morning impairment in cerebral autoregulation and cerebrovascular CO2 reactivity in healthy humans: relation to endothelial function.
        Exp. Physiol. 2007; 92: 769-777
        • Allen L.A.
        • Schmidt J.R.
        • Thompson C.T.
        • Carlson B.E.
        • Beard D.A.
        • Lombard J.H.
        High salt diet impairs cerebral blood flow regulation via salt-induced angiotensin II suppression.
        Microcirculation. 2018; 26e12518
        • Appel L.J.
        • Frohlich E.D.
        • Hall J.E.
        • Pearson T.A.
        • Sacco R.L.
        • Seals D.R.
        • Sacks F.M.
        • Smith S.C.
        • Vafiadis D.K.
        • Van Horn L.V.
        The importance of population-wide sodium reduction as a means to prevent cardiovascular disease and stroke a call to action from the American Heart Association.
        Circulation. 2011; 123: 1138-1143
        • Babcock M.C.
        • Robinson A.T.
        • Migdal K.U.
        • Watso J.C.
        • Wenner M.M.
        • Stocker S.D.
        • Farquhar W.B.
        Reducing dietary sodium to 1000 mg per day reduces neurovascular transduction without stimulating sympathetic outflow.
        Hypertension. 2019; 73: 587-593
        • Babcock M.C.
        • Robinson A.T.
        • Migdal K.U.
        • Watso J.C.
        • Martens C.R.
        • Edwards D.G.
        • Pescatello L.S.
        • Farquhar W.B.
        High salt intake augments blood pressure responses during submaximal aerobic exercise.
        J. Am. Heart Assoc. 2020; 9e015633
        • Brodie F.G.
        • Atkins E.R.
        • Thompson R.G.
        • Panerai R.B.
        Reliability of dynamic cerebral autoregulation measurement using spontaneous fluctuations in blood pressure.
        Clin. Sci. 2009; 116: 513-520
        • Castro P.
        • Serrador J.M.
        • Rocha I.
        • Sorond F.
        • Azevedo E.
        Efficacy of cerebral autoregulation in early ischemic stroke predicts smaller infarcts and better outcome.
        Front. Neurol. 2017; 8: 1-5
        • Claassen J.A.
        • Meel-van den Abeelen A.S.
        • Simpson D.M.
        • Panerai R.B.
        Transfer function analysis of dynamic cerebral autoregulation: a white paper from the International Cerebral Autoregulation Research Network.
        J. Cereb. Blood Flow Metab. 2016; 36: 665-680
        • Cosic A.
        • Jukic I.
        • Stupin A.
        • Mihalj M.
        • Mihaljevic Z.
        • Novak S.
        • Vukovic R.
        • Drenjancevic I.
        Attenuated flow-induced dilatation of middle cerebral arteries is related to increased vascular oxidative stress in rats on a short-term high salt diet.
        J. Physiol. 2016; 594: 4917-4931
        • Coverdale N.S.
        • Gati J.S.
        • Opalevych O.
        • Perrotta A.
        • Shoemaker J.K.
        Cerebral blood flow velocity underestimates cerebral blood flow during modest hypercapnia and hypocapnia.
        J. Appl. Physiol. 2014; 117: 1090-1096
        • Coverdale N.S.
        • Lalande S.
        • Perrotta A.
        • Shoemaker J.K.
        Heterogeneous patterns of vasoreactivity in the middle cerebral and internal carotid arteries.
        Am. J. Physiol. Heart Circ. Physiol. 2015; 308: H1030-H1038
        • Deegan B.M.
        • Sorond F.A.
        • Lipsitz L.A.
        • Ólaighin G.
        • Serrador J.M.
        Gender related differences in cerebral autoregulation in older healthy subjects.
        Conf. Proc. IEEE Eng. Med. Biol. Soc. 2009;
      1. Dietary Guidelines for Americans 2015-2020 [Online].
        https://health.gov/dietaryguidelines/2015/guidelines/
        Date: 2015
        Date accessed: June 20, 2018
        • DuPont J.J.
        • Greaney J.L.
        • Wenner M.M.
        • Lennon-Edwards S.L.
        • Sanders P.W.
        • Farquhar W.B.
        • Edwards D.G.
        High dietary sodium intake impairs endothelium-dependent dilation in healthy salt-resistant humans.
        J. Hypertens. 2013; 31: 530-536
        • Farahmand F.
        • Choobi Anzali B.
        • Heshmat R.
        • Ghafouri H.-B.
        • Hamedanchi S.
        Serum sodium and potassium levels in cerebro-vascular accident patients.
        Malays. J. Med. Sci. 2013; 20: 39-43
      2. FastStats - Diet/Nutrition [Online]. 2021. [date unknown]. https://www.cdc.gov/nchs/fastats/diet.htm [31 Mar. 2020].

        • Frankenfield D.
        • Roth-Yousey L.
        • Compher C.
        Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review.
        J. Am. Diet. Assoc. 2005; 105: 775-789
        • Gardener H.
        • Rundek T.
        • Wright C.B.
        • Elkind M.S.V.
        • Sacco R.L.
        Dietary sodium and risk of stroke in the Northern Manhattan Study.
        Stroke. 2012; 43: 1200-1205
        • Giller C.A.
        The frequency-dependent behavior of cerebral autoregulation.
        Neurosurgery. 1990; 3: 362-368
        • Glodzik L.
        • Randall C.
        • Rusinek H.
        • de Leon M.J.
        Cerebrovascular reactivity to carbon dioxide in Alzheimer’s disease.
        J. Alzheimers Dis. 2013; 35: 427-440
        • Greaney J.L.
        • Dupont J.J.
        • Lennon-Edwards S.L.
        • Sanders P.W.
        • Edwards D.G.
        • Farquhar W.B.
        Dietary sodium loading impairs microvascular function independent of blood pressure in humans: role of oxidative stress.
        J. Physiol. 2012; 590: 5519-5528
        • Kety S.S.
        • Schmidt F.C.
        Effects of alterations in the arterial tensions of carbon dioxide and oxygen on cerebral blood flow and cerebral oxygen consumption of normal young men.
        J. Clin. Invest. 1946; 5: 484-492
        • Lavi S.
        • Gaitini D.
        • Milloul V.
        • Jacob G.
        • Gaitinv D.
        • Millonl V.
        Impaired cerebral C02 vasoreactivity: association with endothelial dysfunction.
        Am. J. Physiol. Heart Circ. Physiol. 2006; 291: H1856-H1861
        • Leffler C.W.
        • Mirro R.
        • Pharris L.J.
        • Shibata M.
        Permissive role of prostacyclin in cerebral vasodilation to hypercapnia in newborn pigs.
        Am. J. Physiol. Circ. Physiol. 1994; 267: H285-H291
        • Lennon-Edwards S.
        • Ramick M.G.
        • Matthews E.L.
        • Brian M.S.
        • Farquhar W.B.
        • Edwards D.G.
        Salt loading has a more deleterious effect on flow-mediated dilation in salt-resistant men than women.
        Nutr. Metab. Cardiovasc. Dis. 2014; 24: 990-995
        • Lindsey M.L.
        • Gray G.A.
        • Wood S.K.
        • Curran-Everett D.
        Statistical considerations in reporting cardiovascular research.
        Am. J. Physiol. Heart Circ. Physiol. 2018; 315: H303-H313
        • Lombard J.H.
        • Sylvester F.A.
        • Phillips S.A.
        • Frisbee J.C.
        High-salt diet impairs vascular relaxation mechanisms in rat middle cerebral arteries.
        Am. J. Physiol. Circ. Physiol. 2003; 284: H1124-H1133
        • Markus H.
        • Cullinane M.
        Severely impaired cerebrovascular reactivity predicts stroke and TIA risk in patients with carotid artery stenosis and occlusion.
        Brain. 2001; 124: 457-467
        • Matthews E.L.
        • Brian M.S.
        • Ramick M.G.
        • Lennon-Edwards S.
        • Edwards D.G.
        • Farquhar W.B.
        High dietary sodium reduces brachial artery flow-mediated dilation in humans with salt-sensitive and salt-resistant blood pressure.
        J. Appl. Physiol. 2015; 118: 1510-1515
        • McEwen S.T.
        • Schmidt J.R.
        • Somberg L.
        • Cruz L. de la
        • Lombard J.H.
        Time-course and mechanisms of restored vascular relaxation by reduced salt intake and angiotensin II infusion in rats fed a high-salt diet.
        Microcirculation. 2009; 16: 220-234
        • Mena L.
        • Pintos S.
        • Queipo N.V.
        • Aizpurua J.A.
        • Maestre G.
        • Sulbaran T.
        A reliable index for the prognostic significance of blood pressure variability.
        J. Hypertens. 2005; 23: 505-511
        • Migdal K.U.
        • Babcock M.C.
        • Robinson A.T.
        • Watso J.C.
        • Wenner M.M.
        • Stocker S.D.
        • Farquhar W.B.
        The impact of high dietary sodium consumption on blood pressure variability in healthy, young adults.
        Am. J. Hypertens. 2020; (February 1)https://doi.org/10.1093/ajh/hpaa014
        • Migdal K.U.
        • Robinson A.T.
        • Watso J.C.
        • Babcock M.C.
        • Lennon S.L.
        • Martens C.R.
        • Serrador J.M.
        • Farquhar W.B.
        A high salt meal does not impair cerebrovascular reactivity in healthy young adults.
        Physiol. Rep. 2020; 8
      3. Nutrition Data System for Research. Nutrition Coordinating Center. Minneapolis, MN. http://www.ncc.umn.edu.

        • Palazzo P.
        • Maggio P.
        • Passarelli F.
        • Altavilla R.
        • Altamura C.
        • Pasqualetti P.
        • Vernieri F.
        Lack of correlation between cerebral vasomotor reactivity and flow-mediated dilation in subjects without vascular disease.
        Ultrasound Med. Biol. 2013; 39: 10-15
        • Panerai R.B.
        • White R.P.
        • Markus H.S.
        • Evans D.H.
        Grading of cerebral dynamic autoregulation from spontaneous fluctuations in arterial blood pressure.
        Stroke. 1998; 29: 2341-2346
        • Ramick M.G.
        • Brian M.S.
        • Matthews E.L.
        • Patik J.C.
        • Seals D.R.
        • Lennon S.L.
        • Farquhar W.B.
        • Edwards D.G.
        Apocynin and tempol ameliorate dietary sodium-induced declines in cutaneous microvascular function in salt-resistant humans.
        Am. J. Physiol. Circ. Physiol. 2019; 317: H97-H103
        • Ringelstein E.B.
        • Van Eyck S.
        • Mertens I.
        Evaluation of cerebral vasomotor reactivity by various vasodilating stimuli: comparison of CO2 to acetazolamide.
        J. Cereb. Blood Flow Metab. 1992; 12: 162-168
        • Robinson A.T.
        • Franklin N.C.
        • Norkeviciute E.
        • Bian J.T.
        • Babana J.C.
        • Szczurek M.R.
        • Phillips S.A.
        Improved arterial flow-mediated dilation after exertion involves hydrogen peroxide in overweight and obese adults following aerobic exercise training.
        J. Hypertens. 2016; 34: 1309-1316
        • Selvarajah V.
        • Mäki-Petäjä K.M.
        • Pedro L.
        • Bruggraber S.F.
        • Burling K.
        • Goodhart A.K.
        • Brown M.J.
        • CM McEniery
        • Wilkinson I.B.
        Novel mechanism for buffering dietary salt in humans effects of salt loading on skin sodium, vascular endothelial growth factor C, and blood pressure buffering dietary salt in humans.
        Hypertension. 2017; 70: 930-937
        • Serrador J.M.
        • Freeman R.
        Enhanced cholinergic activity improves cerebral blood flow during orthostatic stress.
        Front. Neurol. 2017; 8: 1-9
        • Serrador J.M.
        • Picot P.A.
        • Rutt B.K.
        • Shoemaker J.K.
        • Bondar R.L.
        MRI measures of middle cerebral artery diameter in conscious humans during stimulated orthostasis.
        Stroke. 2000; 31: 1672-1678
        • Smirl J.D.
        • Hoffman K.
        • Tzeng Y.-C.
        • Hansen A.
        • Ainslie P.N.
        Methodological comparison of active- and passive-driven oscillations in blood pressure; implications for the assessment of cerebral pressure-flow relationships.
        J. Appl. Physiol. 2015; 119: 487-501
      4. Sodium and Salt [Online]. Am. Hear. Assoc, 2017
        • Strazzullo P.
        • D’Elia L.
        • Kandala N.-B.
        • Cappuccio F.P.
        Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies.
        BMJ. 2009; : 339
      5. Stroke Facts | cdc.gov [Online]. Cent. Dis. Control Prev, 2017
        • van Beek A.H.E.A.
        • Claassen J.A.H.R.
        • Olde Rikkert M.G.M.
        • Jansen R.W.M.M.
        Cerebral autoregulation: an overview of current concepts and methodology with special focus on the elderly.
        J. Cereb. Blood Flow Metab. 2008; 28: 1071-1085
        • Wasserman A.J.
        • Patterson J.L.
        The cerebral vascular response to reduction in arterial carbon dioxide tension.
        J. Clin. Invest. 1961; 40: 1297-1303
        • Yonas H.
        • Smith H.A.
        • Durham S.R.
        • Pentheny S.L.
        • Johnson D.W.
        Increased stroke risk predicted by compromised cerebral blood flow reactivity.
        J. Neurosurg. 1993; 79: 483-489
        • Zhang R.
        • Zuckerman J.H.
        • Giller C.A.
        • Levine B.D.
        Transfer function analysis of dynamic cerebral autoregulation in humans.
        Am. J. Phys. 1998; 274: H233-H241