Salt sensitivity and hypertension.
Olga BalafaRigas G KalaitzidisPublished in: Journal of human hypertension (2020)
Salt sensitivity refers to the physiological trait present in mammals, including humans, by which the blood pressure (BP) of some members of the population exhibits changes parallel to changes in salt intake. It is commoner in elderly, females, Afro-Americans, patients with chronic kidney disease (CKD) and insulin resistance. Increased salt intake promotes an expansion of extracellular fluid volume and increases cardiac output. Salt-sensitive individuals present an abnormal kidney reaction to salt intake; the kidneys retain most of the salt due to an abnormal over-reactivity of sympathetic nervous system and a blunted suppression of renin-angiotensin axis. Moreover, instead of peripheral vascular resistance falling, salt-sensitive subjects present increased vascular resistance due mainly to impaired nitric oxide synthesis in endothelium. Recent studies have shown that part of the dietary salt loading accumulates in skin. Hypertensive and patients with CKD seem to have more sodium in skin comparing to healthy ones. However, we still have not fully explained the link between skin sodium, BP and salt sensitivity. Finally, although salt sensitivity plays a meaningful role in BP pathophysiology, it cannot be used by the physician in everyday patient's care, mainly due to lack of a simple and practical diagnostic test.
Keyphrases
- blood pressure
- nitric oxide
- insulin resistance
- emergency department
- metabolic syndrome
- type diabetes
- chronic kidney disease
- left ventricular
- body mass index
- angiotensin ii
- palliative care
- soft tissue
- gene expression
- dna methylation
- angiotensin converting enzyme
- wound healing
- quality improvement
- case report
- hypertensive patients
- pain management
- glycemic control