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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Salt has played an important role in the human diet since earliest times. However, increases in the availability and consumption of dietary salt have raised concerns that excessive intakes may cause hypertension. Although recent research has linked salt intake to variations in blood pressure, definitive conclusions have been lacking. Uncertainties in this area are due to the complex effects of salt on the cardiovascular system and on blood pressure regulation. Nevertheless, many of these complexities are now well understood and have been summarized in this review. Among the topics we examine are the effects of salt on fluid and electrolyte homoeostasis; potential mechanisms of salt-induced hypertension; the epidemiology of salt intake and blood pressure; the effects of salt restriction and supplementation on blood pressure regulation; the potential roles of sodium and chloride ions, as well as interactions with dietary potassium, calcium, and magnesium; current theories of salt sensitivity; the clinical risks of dietary salt depletion; and the dietary sources of salt.
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PMID:A comprehensive review of the salt and blood pressure relationship. 159 38

To define the role of nurse and pup strain (spontaneously hypertensive rats: SHR nurses and shr pups; Wistar-Kyoto rats: WKY nurses and wky pups) and dietary salt in nurses and pups (low salt and high salt) upon pup body weight and blood pressure, we cross-suckled shr and wky from birth. Nurses after delivery and pups after weaning received either low- or high-salt diets. Pup body weight indicated that WKY dams were better nurses than SHR and that high salt in the nurse and pup diet decreased body weight. At 7 days, WKY on a low-salt diet normalized shr blood pressure and SHR on a high-salt diet reduced shr blood pressure. At 100 days, pup strain strongly affected blood pressure. Salt sensitivity to pup dietary salt depended upon a low-salt diet in nurses. Salt resistance depended on a high-salt diet in WKY nurses. At 300 days, pup strain accounted for most of the blood pressure variability. However, pup diet, pup strain and nurse diet also affected blood pressure (P = 0.05); the blood pressure of shr on a high-salt diet was higher if the nurse was an SHR on a high-salt diet. Thus, nurse environment modulated shr hypertension throughout life.
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PMID:Environmental factor(s) during suckling exert long-term effects upon blood pressure and body weight in spontaneously hypertensive and normotensive rats. 164 58

Insulin resistance associated with a hyperinsulinemic response to oral glucose intake has been found in patients with essential hypertension and is believed to play a role in inducing hypertension by causing renal sodium and water retention. We therefore examined whether salt-sensitive, young normotensives, assumed to be predisposed to essential hypertension, exhibit impaired glucose tolerance in a similar way. The plasma insulin and glucose response to oral glucose intake (75 g) was assessed in 23 healthy, lean, male volunteers ingesting either 20 mmol or 260 mmol NaCl/day for 6 days each in a single-blind randomized crossover study. Salt sensitivity was defined as a significant drop in mean arterial blood pressure greater than 3 mmHg (means of 30 readings in the supine subject; P less than 0.05) under the low-salt diet. Following the glucose load, plasma levels of both glucose and insulin were significantly higher (P less than 0.01) in the salt-sensitive (n = 10) compared with the salt-resistant subjects (n = 13) during the high-salt diet but not during the low-salt diet. Whereas in the salt-sensitive group glucose tolerance improved with dietary salt restriction (P less than 0.01), it deteriorated in the salt-resistant group (P less than 0.05). Following the glucose load under the high-salt diet, there was a significant drop in blood pressure in the salt-sensitive (P less than 0.005) but not the salt-resistant subjects. The hyperglycemic and hyperinsulinemic response in salt-sensitive subjects suggests that insulin resistance is present in these subjects prior to the development of hypertension and that it can be ameliorated by salt restriction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Salt sensitivity in young normotensive subjects is associated with a hyperinsulinemic response to oral glucose. 164 59

We investigated the linkage between high blood pressure and the ACE gene in the F2 generation between SHRSP/Izm and WKY/Izm. The male F2 rats were categorized into 3 genotypes according to a microsatellite polymorphism in the ACE gene. Significantly high blood pressure was observed in the SHRSP homozygotes when it was compared to the blood pressure of the heterozygotes. Further, after 2 or 3 months salt-loading, the blood pressure was significantly higher in the SHRSP homozygotes than in the heterozygotes and the WKY homozygotes. The heterozygotes had a blood pressure similar to that in the WKY homozygotes, indicating that the effect of the ACE gene genotype was recessive. Salt appetite was neither correlated with the salt-sensitivity nor cosegregated with the ACE genotype. The results indicate that the locus of ACE gene associates with the development of hypertension, especially salt-sensitive hypertension.
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PMID:Blood pressure cosegregates with a microsatellite of angiotensin I converting enzyme (ACE) in F2 generation from a cross between original normotensive Wistar-Kyoto rat (WKY) and stroke-prone spontaneously hypertensive rat (SHRSP). 166 4

Objective measures of blood pressure (BP) sensitivity to 72-h salt depletion were evaluated. Salt sensitivity is defined as a measurable decrease of diastolic BP (DBP) after depletion. Changes in office auscultatory and oscillometric DBP were compared with oscillometric ambulatory DBP. In 35 women and men with mild hypertension, 24-h ambulatory DBP; sodium, potassium, albumin, and creatinine in 24-h urine; serum-creatinine; and body weight were measured before and at the end of the salt-free period. The oscillometric method detected larger and more uniform decreases in DBP compared to the auscultatory method. The salt depletion-induced changes in auscultatory DBP but not in ambulatory DBP were positively related to its baseline level. The salt sensitivity was positively related to the age and negatively related to the number of hypertensive symptoms. It was not related to body mass index and body weight decrease after salt depletion. The changes in ambulatory DBP were correlated to changes in office DBP (r = 0.46 for the auscultatory method; r = 0.58 for the oscillometric method). In only half the cases, the direction and size of pressure changes were reflected similarly in all three methods. Although the correlation between the methods points to the biological soundness of the salt sensitivity concept, the individual classification is prone to variation.
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PMID:Salt sensitivity of blood pressure in patients with primary hypertension. 170 35

Salt sensitivity of blood pressure can be identified in half of the hypertensive population and one-fourth of normotensive subjects. Salt sensitivity of blood pressure is especially frequent in normotensives from subpopulations known to have a higher frequency of hypertension, such as blacks, older subjects, and first-degree relatives of hypertensives, suggesting a link between salt and the subsequent development of hypertension. A variety of associated markers of salt sensitivity has been described. Recent studies also link calcium and salt sensitivity of blood pressure.
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PMID:Salt sensitivity as a predictor of hypertension. 178 42

To establish if the benefit of angiotensin converting enzyme inhibitor therapy in retarding progressive diabetic renal injury is due to a specific intrarenal effect of the systemic hypotensive effect, we studied the effect of long-term ramipril treatment on blood pressure, glomerular filtration rate, and urinary protein excretion in streptozotocin-diabetic spontaneously hypertensive rats. The hypotensive effect of ramipril was prevented by a high salt diet, which did not alter the degree of renal angiotensin converting enzyme inhibition. Three weeks after uninephrectomy and induction of diabetes, rats were allocated to three groups. Groups 1 and 2 were given 1% NaCl, whereas group 3 was given water as drinking solution. One week later, groups 2 and 3 received 0.4 mg/kg/day ramipril in their drinking solution, which was continued over a 2-month period. Ramipril produced a blood pressure fall only in water-drinking rats (group 3) despite a similar reduction in plasma and renal angiotensin converting enzyme activity in groups 2 and 3. Salt-loaded rats had a progressive increase in urinary protein excretion over the duration of study. Ramipril treatment prevented an increase in protein excretion only in animals given water and with a reduced systolic blood pressure. Glomerular filtration rate was similar in all three groups. Ramipril treatment improved animal survival independently of a reduction in blood pressure or an effect on proteinuria. Although it is possible that angiotensin converting enzyme inhibitors have specific intrarenal effects reducing progression of diabetic proteinuria, concomitant control of systemic blood pressure appears to be necessary to demonstrate a benefit.
Hypertension 1991 Apr
PMID:Salt blocks the renal benefits of ramipril in diabetic hypertensive rats. 182 92

To investigate the effects of salt loading on cardiopulmonary and arterial baroreceptor reflexes, 34 hypertensive patients underwent two 4-day periods with different dietary sodium intakes (70 and 370 meq/day). The patients were classified as salt-sensitive or salt-resistant depending on whether the mean arterial pressure value obtained on day 4 of high salt intake did or did not increase by 8% or more. In 22 patients cardiopulmonary and carotid baroreceptor reflexes were assessed during each dietary period by measuring the reflex responses to the application of -10 mm Hg lower body negative pressure and of +60 mm Hg increase in neck tissue pressure. Salt-resistant patients (n = 16) retained less sodium than salt-sensitive patients (n = 6) and showed a reduction in plasma norepinephrine and forearm vascular resistance during high sodium intake, whereas the salt-sensitive patients did not. During low sodium diet, no significant differences could be detected in the reflex responses to cardiopulmonary and carotid baroreceptor unloading between the two groups. High salt diet, however, potentiated the gain of cardiopulmonary baroreceptor reflex, which was expressed as the increase in plasma norepinephrine or forearm vascular resistance per millimeter of mercury decrease in pulmonary capillary wedge pressure, only in the salt-resistant hypertensive patients. In addition, the atrial natriuretic factor response to changes in pulmonary capillary wedge pressure was significantly enhanced by high salt intake only in the salt-resistant hypertensive patients. The reflex responses to carotid baroreceptor unloading were unaffected by salt loading in either group. In the remaining 12 patients, the hemodynamic effects of graded lower body negative pressure (-5, -10, -15 mm Hg) and neck tissue positive pressure (+30, +45, +60 mm Hg) were tested for both diets. Again, high salt intake significantly potentiated the cardiopulmonary baroreceptor reflex gain, expressed as the slope of the linear correlation between the changes in forearm vascular resistance (mm Hg/ml/min/100 g) and pulmonary capillary wedge pressure (mm Hg), in salt-resistant (from 3.8 +/- 0.9 to 7.2 +/- 1.0, p less than 0.05) but not in salt-sensitive patients (from 4.2 +/- 0.9 to 3.2 +/- 0.6, NS). In conclusion, the present study demonstrates that high salt diet potentiates cardiopulmonary baroreceptor reflexes and enhances atrial natriuretic factor response in salt-resistant but not in salt-sensitive hypertensive patients. The salt-induced plasticity of cardiopulmonary baroreceptor reflexes may exert a protective effect against the development of salt-induced hypertension by augmenting the reflex vasodilatory response to volume expansion.(ABSTRACT TRUNCATED AT 400 WORDS)
Hypertension 1991 Oct
PMID:Salt-induced plasticity in cardiopulmonary baroreceptor reflexes in salt-resistant hypertensive patients. 183 20

To identify characteristics that may contribute to salt sensitivity, we conducted studies of normal subjects who are at risk for hypertension, namely blacks, subjects older than 40 years of age, and first-degree relatives of subjects with essential hypertension. We also formulated definitions for salt sensitivity and resistance with a short-term volume expansion and contraction protocol and additionally from data derived from studies of long-term reduced dietary salt intake. We examined the effects of augmented potassium and calcium intake and also those of sodium as the chloride or the bicarbonate salt. Finally, we sought genetic markers that are associated with salt sensitivity. We found that salt sensitivity is a function of age and is more common in blacks than whites. These groups also have relatively delayed acute salt excretion compared with controls. We were unable to identify effects of gender. Haptoglobin phenotypes (HP 1-1) may facilitate identification of salt-sensitive individuals. A high potassium intake may make individuals less salt sensitive. Sodium chloride and sodium bicarbonate differ in their effects on blood pressure. Sodium chloride augments urinary calcium excretion, but sodium bicarbonate does not. Differences between susceptible and nonsusceptible groups, together with improved knowledge of electrolyte interactions, may facilitate our understanding of salt-sensitive hypertension.
Hypertension 1991 Jan
PMID:Salt sensitivity and resistance of blood pressure. Age and race as factors in physiological responses. 184 22

Salt sensitivity has been implicated in the age-related increase in blood pressure. We studied the reproducibility of a rapid method for assessing sodium sensitivity and resistance of blood pressure as well as the effect of age on this phenomenon. Blood pressure after volume expansion with 2 l intravenous saline (0.9%) over 4 hours was compared with that after 1 day of 10 mmol sodium chloride intake and 3 and 40 mg oral doses of furosemide. Normal and hypertensive subjects (n = 28) were studied twice within a year. Cross-sectional observations of the effect of age were made from studies in 230 hypertensive and 430 normotensive subjects. Longitudinal observations of blood pressure change over time were made 10 or more years after categorization of sodium responsivity in 31 subjects. The blood pressure response was reproducible in 28 subjects studied twice (r = 0.56, p less than 0.002). Four subjects changed salt-responsiveness status and six were indeterminate on restudy. Sodium sensitivity of blood pressure increased significantly with increasing age in the entire population (n = 660, r = -0.38, p less than 0.001). The relation was more striking in hypertensive subjects (n = 230, r = -0.31, p less than 0.001) in whom a progressive increase in salt sensitivity with decades was seen than in the normotensive group (n = 430, r = -0.19, p less than 0.01) in whom salt sensitivity was not observed until the sixth decade. Salt-sensitive subjects had a significantly greater increase in systolic (p less than 0.001) and diastolic (p less than 0.01) pressure over time than those who were salt-resistant. Salt sensitivity is a reproducible phenomenon that is related to the age-associated increase in blood pressure characteristic of industrialized societies. In addition, salt sensitivity can be shown to be a predictor of subsequent, age-related blood pressure increase.
Hypertension 1991 Jul
PMID:Sodium and volume sensitivity of blood pressure. Age and pressure change over time. 186 Jul 13


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