The hidden hand of chloride in hypertension

Abstract

Among the environmental factors that affect blood pressure, dietary sodium chloride has been studied the most, and there is general consensus that increased sodium chloride intake increases blood pressure. There is accruing evidence that chloride may have a role in blood pressure regulation which may perhaps be even more important than that of Na+. Though more than 85 % of Na+ is consumed as sodium chloride, there is evidence that Na+ and Cl− concentrations do not go necessarily hand in hand since they may originate from different sources. Hence, elucidating the role of Cl− as an independent player in blood pressure regulation will have clinical and public health implications in addition to advancing our understanding of electrolyte-mediated blood pressure regulation. In this review, we describe the evidence that support an independent role for Cl− on hypertension and cardiovascular health.

The chloride anion as a signalling effector

“…Knowledge of its three-dimensional (3D) structure allowed a better understanding of how Cl − could function in ACE activation, although the exact sites of Cl − action and specificity are still a matter of debate (Zhang, Wu & Xu, 2013;Masuyer et al, 2014). It is now thought that Cl − , and not only Na + , may have an important role in hypertension (McCallum, Lip & Padmanabhan, 2015). The binding of Cl − to ACE has been also useful in studies investigating the effects of Cl − in Photosystem II, α-amylase and other Cl − -modulated enzymes (Coleman, 1990).…”

A Review of the Alleged Health Hazards of Monosodium Glutamate

“…Dietary use of sodium chloride (NaCl) was associated with noticeable odor and flavor enhancement effects (Ventanas, Mustonen, Puolanne, & Tuorila, 2010). However, it is well known that high dietary sodium (Na + ) intake is linked to an increase of blood pressure, and more than 85% of Na + is being consumed as table salt (McCallum, Lip, & Padmanabhan, 2015). MSG can be used to substitute NaCl as a flavor enhancer in lowsodium products, as it does not substantially increase the total Na + content, while the pleasantness of reduced-salt foods was reported to increase upon its addition (Roininen, Lahteenmaki, & Tuorila, 1996).…”

Pharmacovigilance database search discloses ClC‐K channels as a novel target of the AT1 receptor blockers valsartan and olmesartan

“…ClC‐K genes have been designated as being among candidate genes predisposing to hypertension (Barlassina et al, ; Denton et al, ; McCallum et al, ) and ClC‐K blockers could offer new opportunities to treat this disorder, with a beneficial increase in water diuresis and few systemic effects (Liantonio et al, , ). Thus, the discovery of ClC‐K ligands could be pivotal for a proper treatment of both rare dysfunctions of ClC‐K channels, which still lack specific therapies, and more common diseases, such as hypertension.…”