Diagnostic tools for hypertension and salt sensitivity testing

Abstract

Purpose of review One-third of the world’s population has hypertension and it is responsible for almost 50% of deaths from stroke or coronary heart disease. These statistics do not distinguish salt-sensitive from salt-resistant hypertension or include normotensives who are salt-sensitive even though salt sensitivity, independent of blood pressure, is a risk factor for cardiovascular and other diseases, including cancer. This review describes new personalized diagnostic tools for salt sensitivity. Recent findings The relationship between salt intake and cardiovascular risk is not linear, but rather fits a J-shaped curve relationship. Thus, a low-salt diet may not be beneficial to everyone and may paradoxically increase blood pressure in some individuals. Current surrogate markers of salt sensitivity are not adequately sensitive or specific. Tests in the urine that could be surrogate markers of salt sensitivity with a quick turn-around time include renal proximal tubule cells, exosomes, and microRNA shed in the urine. Summary Accurate testing of salt sensitivity is not only laborious but also expensive, and with low patient compliance. Patients who have normal blood pressure but are salt-sensitive cannot be diagnosed in an office setting and there are no laboratory tests for salt sensitivity. Urinary surrogate markers for salt sensitivity are being developed.

Increased Salt Sensitivity of Ambulatory Blood Pressure in Women With a History of Severe Preeclampsia

“…8,11,22 As published by Castiglioni 23 and Bursztyn, 15 we also evaluated the salt sensitivity on a continuous basis through the use of sodium sensitivity index. The sodium sensitivity index was calculated as the ratio between Δmean arterial pressure (MAP, mm Hg) and the difference between urinary sodium excretion rates (ΔU Na V, mmol/d) on a LS and HS diets, expressed by the formula sodium sensitivity index=ΔMAP/ΔU Na V×1000 (mm Hg/mol per day).…”

“…[8][9][10] Salt sensitivity is traditionally defined as an increase in office BP of 5% to 10% or an increase in mean ambulatory BP (ABP) of ≥4 mm Hg with an increase in sodium intake. 11 Several factors contribute to the development of salt sensitivity in humans, including aging and changes in renal function, and also hormonal and genetic factors. [12][13][14] The profile of sex hormones has also been shown to affect the salt sensitivity of BP.…”

<b>Blood pressure, renal biochemical parameters and histopathology in an original rat model of essential hypertension (SHRSP/Kpo </b><b>strain) </b>

“…Essential hypertension is a heterogeneous disorder in which both genetics and environmental factors contribute to increased cardiovascular disease and mortality (5,13). The number of patients with this disease is still increasing despite the development of various treatments to normalize systemic blood pressure (19).…”

Research Progress of Marinobufagenin and Salt-Sensitive Hypertension

“…Some people have significant blood pressure increase after high salt intake is called salt-sensitive subjects, while the other group have no obvious increase in blood pressure is called non-salt-sensitive subjects. SSH is an important characteristic of hypertension in China, affects approximately 50% of hypertensive patients, 25% of normotensive adults (Kotchen et al, 2013;Felder et al, 2013 ) and about 40% of the teenages have salt sensitivity in positive family history of hypertension (Mou et al, 2012). It is a complex disease related to regional, ethnic, demographic and social factors, as well as an independent risk factor for cardiovascular disease.…”

“…Salt sensitivity is the genetic basis of salt connects hypertension, is an intermediate genetic phenotype of essential hypertension. The salt sensitivity of blood pressure, defined as an exaggerated pressor response to dietary salt intake, jointly determined by genetic factors, age, body mass index (BMI), concomitant diseases, ethnic factor, increases the risk of hypertension (Carey et al, 2012; Kotchen et al, 2013;Felder et al, 2013;Frame et al, 2017), and the associated hypertension defined as salt sensitivity hypertension (salt-sensitive hypertension, SSH). Some people have significant blood pressure increase after high salt intake is called salt-sensitive subjects, while the other group have no obvious increase in blood pressure is called non-salt-sensitive subjects.…”