Association between salt sensitivity and target organ damage in essential hypertension

Abstract

Cardiovascular events occur more frequently in sodium-sensitive patients with essential hypertension; recently, sodium sensitivity was shown to be a cardiovascular risk factor independently of other classic factors such as blood pressure and cigarette smoking This study examined the relationship between salt sensitivity status and target organ damage in hypertensive patients. Ninety-six patients (35 men, 61 women) with moderate essential hypertension were studied for salt sensitivity status and the presence of target organ damage, including hypertensive retinopathy, serum creatinine, creatinine clearance, and urinary albumin excretion (UAE). Four different patterns of left ventricular anatomic adaptation were identified by categorizing patients according to the values of left ventricular mass index and relative wall thickness by the means of echocardiography. Forty-five (47%) patients were shown to be salt-sensitive, in contrast to 51 (53%) salt-resistant subjects. Serum creatinine and UAE were significantly higher in the group of salt-sensitive hypertensives (P < .05 and P < .001, respectively). Left ventricular mass index (LVMI), relative wall thickness (RWT), and left atrial index (LAI) were all significantly higher in the group of salt-sensitive hypertensive patients. Concentric hypertrophy was significantly more prevalent in the salt-sensitive group (37.8% v 11.8%; P < .01). The prevalence of hypertensive retinopathy in the salt-sensitive group was 84.4%, in contrast to 59.6% in the salt-resistant group (P < .01). Multivariate regression analysis revealed salt sensitivity as a significant predictor of LVMI, RWT, and UAE, independently of age, body mass index, and mean blood pressure. In conclusion, salt-sensitive hypertensive patients are more prone to develop severe hypertensive target organ damage that may enhance their risk of renal and cardiovascular morbidity.

NAD(P)H oxidase p22phox gene C242T polymorphism, nitric oxide production, salt sensitivity and cardiovascular risk factors in Hispanics

“…11,12,[29][30][31][32][33] Establishing the genes involved in the BP reactivity to salt would help in identifying patients who would benefit from salt restriction, as well as in preventing salt-sensitive hypertension, a condition known to be associated with increased risk for cardiovascular events. [34][35][36][37][38] In this study, we demonstrated that women with the T allele were more salt sensitive than those without the polymorphism. Interestingly, such an association was not found in men.…”

Increased blood pressure reactivity to dietary salt in patients with the metabolic syndrome

“…[7][8][9] Exaggerated BP reactivity to salt, known as salt sensitivity, is associated with increased risk for cardiovascular events. [10][11][12][13][14] Although genetic and acquired factors play a role in the pathogenesis of salt sensitivity, its aetiology is unknown. Older age and insulin resistance have been reported to be associated with salt sensitivity.…”

Effects of lifestyle changes and metformin on salt sensitivity and nitric oxide metabolism in obese salt-sensitive Hispanics

“…[1][2][3][4][5] Although the pathogenesis of salt sensitivity is unknown, both genetic and environmental factors appear to interact to determine the exaggerated BP response to changes in salt intake. [6][7][8][9][10][11][12][13][14][15] Increased reactivity of BP to salt is commonly observed in subjects with obesity and associated cardiovascular risk factors.…”