Reducing pharmaceutical sodium content helps manage BP elevations in narcolepsy

In patients with narcolepsy, switching from high- to low-sodium oxybate results in substantial reductions in daily medication-related sodium intake and, in turn, blood pressure levels (BP), according to a study.

The study included 43 patients (mean age 45 years, 65 percent female, 33 percent on antihypertensives) with narcolepsy and office systolic BP level ranging between 130 and 155 mm Hg who were taking twice-nightly high-sodium oxybate for ≥6 weeks. These patients were switched to low-sodium oxybate or continued treatment at the same dose during the intervention period of up to 6 weeks.

Changes in mean 24-h ambulatory systolic BP at the end of treatment were evaluated as the primary endpoint. Secondary and exploratory endpoints included changes in diastolic BP, office BP, and 24-h sodium excretion.

At baseline, the patients had a mean office BP of 138.0/85.2 mm Hg. The mean total nightly high-sodium oxybate dose was 8 g, which translated to a mean sodium content of 1,456.5 mg. During the intervention, the patients switched to a low-sodium oxybate dose of 8.1 g/night, representing a mean sodium content of 117.8 mg.

The mean 24-h ambulatory systolic BP dropped from 132.3 mm Hg at baseline to 128.2 mm Hg at the end of the intervention (mean change, −4.1 mm Hg, 95 percent confidence interval, −6.9 to −1.4; p=0.0019). Substantial improvements were also observed in other endpoints.

The present data underscore the importance of reducing pharmaceutical sodium content in a population that already has an increased cardiovascular risk.