Skip to main content
Log in

Effects of enalapril and hydrochlorothiazide on the salt-induced cardiac and renal hypertrophy in normotensive rats

  • Original Articles
  • Published:
Naunyn-Schmiedeberg's Archives of Pharmacology Aims and scope Submit manuscript

Abstract

Recent studies have shown that, not only in hypertensive animals but even in normotensive rats, dietary salt (sodium chloride) produces a dose-related increase in the left ventricular and renal mass. In the present study the effects of the angiotensin converting enzyme inhibitor (ACEI) enalapril and the thiazide-type diuretic, hydrochlorothiazide, on the development of the salt-induced left ventricular and kidney hypertrophy were examined in normotensive Wistar-Kyoto and Wistar rats. A high intake of sodium chloride (6% of the dry weight of the chow to mimic the level found in many human food items) during eight weeks produced a marked increase in the mass of the left ventricle and the kidneys in both rat strains with little or no effect on blood pressure. The cardiac hypertrophy correlated strongly with the renal hypertrophy. These salt-induced changes in the heart and in the kidneys were completely blocked by hydrochlorothiazide, while enalapril was devoid of any significant effects during the high-salt diet. However, during a low-salt diet enalapril, but not hydrochlorothiazide, effectively lowered the blood pressure and decreased the left ventricular mass of the normotensive rats. There was a 3- to 4-fold increase in the urinary excretion of calcium during the high intake of sodium chloride. Hydrochlorothiazide decreased the urinary excretion of calcium even during the low salt diet, and it completely blocked the salt-induced hypercalciuria. Enalapril had no significant effect on the urinary calcium excretion. During the low-salt diet hydrochlorothiazide increased the calcium and decreased the potassium concentration in the heart while enalapril increased the phosphorus concentration.

In conclusion, a high intake of sodium chloride produced hypertrophy both in the heart and in the kidneys, even in the absence of a rise in blood pressure. Salt also remarkably increased the urinary calcium excretion. These harmful effects of salt were blocked by the thiazide diuretic hydrochlorothiazide but not by the ACEI enalapril. However, this study does not allow to make any direct comparison between the effects of enalapril and hydrochlorothiazide.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Adams MA, Bobik A, Kerner PI (1990) Enalapril can prevent vascular amplifier development in spontaneously hypertensive rats. Hypertension 16:252–260

    Google Scholar 

  • Arvola P, Ruskoaho H, Wuorela H, Pekki A, Vapaatalo H, Pörsti I (1993) Quinapril treatment and arterial smooth muscle responses in spontaneously hypertensive rats. Br J Pharmacol 108:980–990

    Google Scholar 

  • Barry WH, Bridge JHB (1993) Intracellular calcium homeostasis in cardiac myocytes. Circulation 87:1806–1815

    Google Scholar 

  • Brilla CG, Janicki JS, Weber KT (1991) Cardioreparative effects of lisinopril in rats with genetic hypertension and left ventricular hypertrophy. Circulation 83:1771–1779

    Google Scholar 

  • Childs TJ, Adams MA, Mak AS (1990) Regression of cardiac hypertrophy in spontaneously hypertensive rats by enalapril and the expression of contractile proteins. Hypertension 16:662–668

    Google Scholar 

  • Clozel J-P, Kuhn H, Hefti F (1989) Effects of chronic ACE inhibition on cardiac hypertrophy and coronary vascular reserve in spontaneously hypertensive rats with developed hypertension. J Hypertens 7:267–275

    Google Scholar 

  • Dahlöf B, Pennert K, Hansson L (1992) Reversal of left ventricular hypertrophy in hypertensive patients. A meta-analysis of 109 treatment studies. Am J Hypertens 5:95–110

    Google Scholar 

  • de Wardener HE (1990a) The primary role of the kidney and salt intake in the aetiology of essential hypertension: part I. Clin Sci 79:193–200

    Google Scholar 

  • de Wardener HE (1990b) The primary role of the kidney and salt intake in the aetiology of essential hypertension: part II. Clin Sci 79:289–297

    Google Scholar 

  • DiBona GF (1985) Effects of felodipine on renal function in animals. Drugs 29 [Suppl 2]:168–175

    Google Scholar 

  • du Cailar G, Ribstein J, Grolleau R, Mimran A (1989) Influence of sodium intake on left ventricular structure in untreated essential hypertensive. J Hypertens 7:S258–259

    Google Scholar 

  • Erwteman TM, Nagelkerke N, Lubsen J, Koster M, Dunning AJ (1984) β-blockade, diuretics, and salt restriction for the management of mild hypertension: a randomised double blind trial. Br Med J 289:406–409

    Google Scholar 

  • Fields NG, Yuan B, Leenen FHH (1991) Sodium-induced cardiac hypertrophy. Cardiac sympathetic activity versus volume load. Circ Res 68:745–755

    Google Scholar 

  • Fleckenstein-Grun G, Frey M, Thimm F, Hofgartner W, Fleckenstein A (1992) Calcium overload- and important cellular mechanism in hypertension and arteriosclerosis. Drugs 44 [Suppl 1]:23–30

    Google Scholar 

  • Friberg P, Ely DL, Wåhlander N, Nilsson H, Folkow B (1986) Cardiac design and pressure-volume characteristics of the left ventricle in normotensive (WKY) and hypertensive (SHR) rats after various dietary sodium treatments. Acta Physiol Scand 126:477–484

    Google Scholar 

  • Frohlich ED, Apstein C, Chobanian AV, Devereux RB, Dustan HP, Dzau V, Fauad Tarazi F, Horan MJ, Marcus M, Massie B, Pfeffer MA, Re RN, Roccella EJ, Savage D, Shub C (1992) The heart in hypertension. N Engl J Med 327:998–1008

    Google Scholar 

  • Frost CD, Law MR, Wald NJ (1991) By how much does diatary salt reduction lower blood pressure? II—Analysis of observational data within populations. Br Med J 302:815–818

    Google Scholar 

  • Geven WB, Vogels-Mentink GM, Willems JL, de Boo T, Lemmens W, Monnens LAH (1990) Reference values of magnesium and potassium in mononuclear cells and erythrocytes of children. Clin Chem 36:1323–1327

    Google Scholar 

  • Hall C, Karlberg BE (1986) Plasma concentration of angiotensin II and aldosterone during acute left ventricular failure in the dog. Res Exp Med 186:387–395

    Google Scholar 

  • Karppanen H (1990) Epidemiologic evidence for considering magnesium deficiency as a risk factor for cardiovascular diseases. Magnesium Bull 12:80–86

    Google Scholar 

  • Kihara M, Utagawa N, Mano M, Nara Y, Horie R, Yamori Y (1985) Biochemical aspects of salt-induced, pressure-independent left ventricular hypertrophy in rats. Heart Vessels 1:212–215

    Google Scholar 

  • Laakso JT, Tikkanen H, Michelsson J-E (1991) Element concentrations in normal and immobilization-induced necrotic rabbit muscles. Trace Elem Med 8:34–42

    Google Scholar 

  • Law MR, Frost CD, Wald NJ (1991a) By how much does dietary salt reduction lower blood pressure? I — Analysis of observational data among populations. Br Med J 302:811–815

    Google Scholar 

  • Law MR, Frost CD, Wald NJ (1991b) By how much does dietary salt reduction lower blood pressure? III — Analysis of data from trials of salt reduction. Br Med J 302:819–824

    Google Scholar 

  • Leenen FHH, Toal CB (1989) Dietary sodium restriction and the reninangiotensin system in young spontaneously hypertensive rats. J Hypertens 7:57–61

    Google Scholar 

  • Lim RA, Forney RB, Henderson FG, Martz BL (1966) Changes in tissue electrolytes following the prolonged administration of hydrochlorothiazide. Clin Res 14:477

    Google Scholar 

  • Lindpaintner K, Ganten D (1991) The cardiac renin-angiotensin system. An appraisal of present experimental and clinical evidence. Cite Res 68:905–921

    Google Scholar 

  • Lund DD, Tomanek RJ (1978) Myocardial morphology in spontaneously hypertensive and aortic-constricted rats. Am J Anat 152:141–152

    Google Scholar 

  • MacGregor GA, Cappuccino FP (1993) The kidney and essential hypertension: a link to osteoporosis? J Hypertens 11:781–785

    Google Scholar 

  • Martell N, Rodrigo JL, Fernandez-Pinilla C, Gutkowska J, Fernandez-Cruz A, Vivas F, Ramon MC, Pascual MJ, Luque-Utero M (1991) Sodium intake and atrial natriuretic factor as determinants of left ventricular dimensions: the Torrejon study. J Hypertens 9:5258–5259

    Google Scholar 

  • Matthews JNS, Altman DG, Campbell MJ, Royston P (1990) Analysis of serial measurements in medical research. Br Med J 300:230–235

    Google Scholar 

  • McCormick CP, Rauch AL, Buckalew Jr WM (1989) Differential effect of dietary salt on renal growth in Dahl salt-sensitive and salt-resistant rats. Hypertension 13:122–127

    Google Scholar 

  • Meggs LG, Ben-Ari J, Gammon D, Goodman AI (1988) Myocardial hypertrophy: The effect of sodium and the role of sympathetic nervous system activity. Am J Hypertens 1:11–15

    Google Scholar 

  • Mervaala EMA, Himberg J-J, Laakso J, Tuomainen P, Karppanen H (1992) Beneficial effects of a potassium and magnesium-enriched salt alternative. Hypertension 19:535–540

    Google Scholar 

  • Mervaala EMA, Laakso J, Karppanen H (1994a) Cardiovascular effects of felodipine are not antagonized by dietary salt. Eur J Pharmacol 255:73–79

    Google Scholar 

  • Mervaala EMA, Laakso J, Himberg J-J, Karppanen H (1994b) Replacement of regular salt by a novel salt alternative improves the cardiovascular effects of the ACE inhibitor enalapril. Hypertension Res 17:59–69

    Google Scholar 

  • Mervaala EMA, Laakso J, Vapaatalo H, Karppanen H (1994c) Improvement of cardiovascular effects of metoprolol by replacement of common salt with a potassium- and magnesium-enriched salt alternative. Br J Pharmacol 112:640–648

    Google Scholar 

  • Mervaala EMA, Paakkari I, Laakso J, Nevala R, Teravainen T-L, Fyhrquist F, Vapaatalo H, Karppanen H (1994d) Replacement of salt by a novel potassium- and magnesium-enriched salt alternative improves the cardiovascular effects of ramipril. Br J Pharmacol 111:1189–1197

    Google Scholar 

  • Mooser V, Casley D, Trinder D, Paxton DL, Johnston CI (1991) Reduction in left ventricular mass in normotensive and spontaneously hypertensive rats given enalapril. Clin Exp Pharmacol P 18:341–344

    Google Scholar 

  • Nagano M, Higaki J, Mikami H, Nakamura M, Higashimori K, Katahira K, Tabuchi Y, Moriguchi A, Nakamura F, Okihara T (1991) Converting enzyme inhibitors regressed cardiac hypertrophy and reduced tissue angiotensin II in spontaneously hypertensive rats. J Hypertens 9:595–599

    Google Scholar 

  • Neaton JD, Grimm RH, Prineas RJ, Stamler J, Grandits GA, Elmer PJ, Cutler JA, Flack JM, Schoenberger JA, McDonald R, Lewis CE, Liebson PR (1993) Treatment of mild hypertension study. Final results. JAMA 270:713–724

    Google Scholar 

  • Neuvonen P (1971) Influence of diuretics and diazoxide on ions and vascular reactivity in normotensive and spontaneously hypertensive rats. Ann Med Exp Biol Fenn 49:41–51

    Google Scholar 

  • Ohtaka M (1980) Vectorcardiographical and pathological approach to the relationship between cardiac hypertrophy and the coronary arteriosclerosis in spontaneously hypertensive rats (SHR). Jpn Circ J 44:283–293

    Google Scholar 

  • Pfeffer JM, Pfeffer MA, Mirsky I, Braunwald E (1982) Regression of left ventricular hypertrophy and prevention of left ventricular dysfunction by captopril in the spontaneously hypertensive rat. Proc Natl Acad Sci 79:3310–3314

    Google Scholar 

  • Samizadeh A, Losse H, Wessels F (1977) Einfluß von Kochsalz und Beta-Sympathikolytica auf den Blutdruckverlauf der erblichen spontanen Hypertonie der Ratte. Med Welt 28:2050–2054

    Google Scholar 

  • Sapirstein LA, Brandt WL, Drury DR (1950) Production of hypertension in the rat by substituting hypertonic sodium chloride solutions for drinking water. Proc Soc Exp Biol Med 73:82–85

    Google Scholar 

  • Schmieder RE, Messerli FH, Garagavlia GE, Nunez BD (1988) Dietary salt intake: A determinant of cardiac involvement in essential hypertension. Circulation 78:951–956

    Google Scholar 

  • Schmieder RE, Grube E, Impelmann V, Ruddel H, Schulte W (1990) Determinanten fur die myocardiale Hypertrophie bei der milden essentiellen Hypertonie. Z Kardiol 79:557–564

    Google Scholar 

  • Schmieder RE, Fick G, Gatzka C, Reusch P (1992) How dietary salt intake exerts blood pressure independent effects on left ventricular hypertrophy (LHV). (abstract). J Hypertens 10:S 150

    Google Scholar 

  • Schunkert H, Dzau VJ, Tang SS, Hirsch AT, Apstein CS, Lorell BH (1990) Increased rat cardiac angiotensin converting enzyme activity and mRNA expression in pressure overload left ventricular hypertrophy. Effects on coronary resistance, contractility, and relaxation. J Clin Invest 86:1913–1920

    Google Scholar 

  • Seelig MS (1980) Magnesium deficiency in the pathogenesis of disease: Early roots of cardiovascular, skeletal, and renal abnormalities. Plenum Medical Book Co., New York

    Google Scholar 

  • Shortt C, Flynn A (1990) Sodium-calcium interrelationships with specific reference to osteoporosis. Nutr Res Rev 3:101–115

    Google Scholar 

  • Stier CT Jr, Benter IF, Ahmad S, Zuo HL, Selig N, Roethel S, Levine S, Itskovitz HD (1989) Enalapril prevents stroke and kidney dysfunction in salt-loaded stroke-prone spontaneously hypertensive rats. Hypertension 13:115–121

    Google Scholar 

  • Tobian L (1977) Salt and hypertension. In: Genest J, Koiw E, Kuchel O (eds) Hypertension. Physiopathology and treatment. McGraw Hill, New York, pp 423–433

    Google Scholar 

  • Tobian L (1991) Salt and hypertension. Lessons from animal models that relate to human hypertension. Hypertension 17 [Suppl I]:52–58

    Google Scholar 

  • Tobian L, Lange J, Iwai J, Hiller K, Johnson MA, Goossens P (1979) Prevention with thiazide of NaCl-induced hypertension in Dahl “S” rats. Evidence for a Na-retaining Immoral agent in “S” rats. Hypertension 1:316–323

    Google Scholar 

  • Tsuda K, Masuyama Y (1991) Inhibition of norepinephrine release from vascular adrenergic neurons by oral administration of β-blocker in DOCA-salt hypertension. Am J Hypertens 4:68–71

    Google Scholar 

  • Vapaatalo HI, Lahovaara S, Hackman R (1970) Studies with renal hypertensive rats. Ann Med Exp Fenn 48:28–32

    Google Scholar 

  • Waeber B, Nussberger J, Brunner HR (1990) Angiotensin-converting-enzyme inhibitors in hypertension. In: Brenner BM, Laragh JH (eds) Hypertension: pathophysiology, diagnosis, and management. Raven Press, New York, pp 2209–2232

    Google Scholar 

  • Weiner IM (1990) Diuretics and other agents employed in the mobilization of edema fluid. In: Goodman Gilman A, Rall TW, Nies AS, Taylor P (eds) Goodman and Gilman's The pharmacological basis of therapeutics. Pergamon Press, New York, pp 713–742

    Google Scholar 

  • Wiemer G, Scholkens BA, Becker RHA, Busse R (1991) Ramiprilat enhances endothelial autacoid formation by inhibiting breakdown of endothelium-derived bradykinin. Hypertension 18:558–563

    Google Scholar 

  • Wilson RB, Smith DM, Newberne PM (1973) Excess sodium chloride intake in neonatal rats. Arch Pathol 96:372–376

    Google Scholar 

  • Wuorela H, Pörsti I, Arvola P, Mäkynen H, Vapaatalo H (1992) Three levels of dietary calcium-effects on blood pressure and electrolyte balance in spontaneously hypertensive rats. Naunyn-Schmiedeberg's Arch Pharmacol 346:542–549

    Google Scholar 

  • Yuan B, Leenen FHH (1991) Dietary sodium intake and left ventricular hypertrophy in normotensive rats. Am J Physiol 261:H1397–H1401

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Correspondence to: E. Mervaala at the above address

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mervaala, E.M.A., Laakso, J., Vapaatalo, H. et al. Effects of enalapril and hydrochlorothiazide on the salt-induced cardiac and renal hypertrophy in normotensive rats. Naunyn-Schmiedeberg's Arch Pharmacol 350, 416–425 (1994). https://doi.org/10.1007/BF00178961

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00178961

Key words

Navigation