{"id":"972c9d4beb6c","type":"article","url":"https://hartvaat.nl/2025/12/01/hoog-versus-laag-natrium-oxybaat-en-bloeddruk-bij-narcolepsie/","title":"Hoog versus laag natrium-oxybaat en bloeddruk bij narcolepsie","title_en":"Effects of High- Versus Low-Sodium Oxybate on Blood Pressure in Patients With Narcolepsy.","category":"hypertensie","category_label":"Hypertensie","professions":["internist"],"tags":[],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.125.25730","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.125.25730","authors":["William B White","Richard J Kovacs","Jessica K Alexander","Christine Baranak","Deborah A Nichols","Douglas S Fuller","Jing Dai","Marisa Whalen","Akinyemi Ajayi","Barbara Hutchinson","Yves Dauvilliers","Virend K Somers"],"significance":5,"published":"2025-12-01","source_date":"2025-12-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/","https://hartvaat.nl/kennis/farmacologie/mineralocorticoid-antagonisten-farmacologie/"],"congress":"","summary_en":"This study compared the blood pressure effects of high- versus low-sodium oxybate in patients with narcolepsy and elevated blood pressure. The sodium load significantly influenced blood pressure, which is clinically relevant for patients with comorbid hypertension.","created":"2026-07-03T10:32:02Z","updated":"2026-07-03T13:31:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie vergeleek het bloeddrukeffect van hoog- versus laag-natriumoxybaat bij narcolepsie. De natriumbelasting beïnvloedt de bloeddruk significant, wat relevant is bij comorbide hypertensie.","abstract_original":"BACKGROUND: People with narcolepsy are at increased risk for hypertension and cardiovascular disease; excessive sodium intake is linked to both. METHODS: We studied patients with narcolepsy and office systolic blood pressures (BPs) of 130 to 155 mm Hg taking twice-nightly high-sodium oxybate for ≥6 weeks who switched to low-sodium oxybate at the same dosage. The primary end point was the change from baseline in mean 24-hour ambulatory systolic BP at the end of treatment (≈6 weeks after switching). Secondary and exploratory end points included changes in diastolic BP, office BP, and 24-hour sodium excretion. RESULTS: Patients (n=43) had a mean age of 45 years, were 65% female, 33% on antihypertensives, with baseline mean (SD) office BP of 138.0/85.2 (5.7/6.6). Mean (SD) total high- and low-sodium oxybate dosages of 8.0 (1.1) and 8.1 (1.1) g/night, respectively, represented 1456.5 (206.2) and 117.8 (16.3) mg of sodium. The median 24-hour urinary sodium was 4278 mg/d at baseline and 2703 mg/d at the end of treatment (median change, 1288 mg/d). Mean (SE) 24-hour ambulatory systolic BPs at baseline and study end were 132.3 (1.8) and 128.2 (1.8) mm Hg (least-squares mean change, -4.1 [95% CI, -6.9 to -1.4] mm Hg; 1-sided P=0.0019). BP changes by narcolepsy subtype, sex, body mass index, baseline office BP, and baseline antihypertensive use were consistent with the overall effect size. CONCLUSIONS: People with narcolepsy switching from high- to low-sodium oxybate showed substantially reduced daily medication-related sodium intake and significant 24-hour BP reductions. These results demonstrate the importance of reducing pharmaceutical sodium content in this elevated cardiovascular risk patient population. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05869773."}