Low-Pressure Receptor Activity and Exaggerated Natriuresis in Essential Hypertension

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Abstract
Urinary Na excretion, central hemodynamics and mean arterial pressure (MAP) were studied in 7 normal subjects and 19 hypertensive patients during both central hypervolemia by water immersion to the neck (NI) and extracellular volume expansion by i.v. saline infusion. During 2 h NI, 12 out of the 19 hypertensives exhibited a significant fall in MAP (P < 0.001). Exaggerated natriuresis did not occur in these patients [not significant]. In the remaining 7 hypertensive patients in whom, MAP was unchanged during NI, exaggerated natriuresis was found (P < 0.001). During saline infusion, MAP was either unchanged or increased and exaggerated natriuresis was found in all hypertensive patients (P < 0.001) previously submitted to NI. A high MAP is apparently a major determinant of exaggerated natriuresis in arterial hypertension.