Oral Fludrocortisone Test for Salt-Sensitive Screening in Hypertensive Patients: A Randomized Crossover Trial

Autor(es)

Pio-Abreu, Andrea ; de Castro, Isac ; da Silva, Giovanio Vieira ; Ortega, Katia Coelho ; Mion, Decio, Jr.

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF HYPERTENSION; v. 2018, p. 6-pg., 2018-01-01.

Resumo

Background. Salt sensitivity is associated with an increased cardiovascular risk, but the gold standard method (diet cycles) requires 24-h urine samples and has poor patient compliance. Objectives. Test the hypothesis that oral fludrocortisone (0.4 mg per day for 7 days) is a good alternative in identifying salt-sensitive patients. Methodology. We conducted a randomized crossover study with 30 hypertensive individuals comprising the following steps: (1) washout; (2) phase A (low-and high-sodium diet cycles); (3) washout 2; (4) phase B (fludrocortisone test). Phase A and B steps were performed in a random way. Consistent with the literature, we found that 53.3% were salt-sensitive according to the reference test. Using the ROC curve, the fludrocortisone test defined salt sensitivity by a median blood pressure increase of >= 3 mmHg. A good accuracy of fludrocortisone in detecting salt sensitivity was observed (AUC: 0.732 +/- 0.065; p<0.001), with 80% sensitivity and 53% specificity. Conclusion. The fludrocortisone test is a good option for screening salt sensitivity in hypertensive patients. However, the low specificity prevents this test from being an ideal substitute to the labor-intensive diet cycles exam in the definition of salt sensitivity. (AU)

• Processo FAPESP: 10/17072-6 - Teste rápido da Fludrocortisona na identificação da sensibilidade a sal
• Beneficiário: Decio Mion Junior
• Modalidade de apoio: Auxílio à Pesquisa - Regular