Inverse salt sensitivity in normotensive adults: role of demographic factors.


Journal

Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882

Informations de publication

Date de publication:
01 06 2023
Historique:
pmc-release: 01 06 2024
medline: 5 5 2023
pubmed: 18 3 2023
entrez: 17 3 2023
Statut: ppublish

Résumé

Salt sensitivity and inverse salt sensitivity [ISS; a reduction in blood pressure (BP) on a high sodium diet] are each associated with increased incidence of hypertension. The purpose of this analysis was to determine the prevalence of ISS in normotensive adults and whether ISS is associated with any demographic characteristic(s). Healthy normotensive, nonobese adults [ n  = 84; 43 women; age = 37 ± 13 years; baseline mean arterial pressure (MAP) = 89 ± 8 mmHg] participated in a controlled feeding study, consuming 7-day low-sodium (20 mmol sodium/day) and high-sodium (300 mmol sodium/day) diets. Twenty-four-hour ambulatory BP was assessed on the last day of each diet. ISS was defined as a reduction in 24-h MAP more than 5 mmHg, salt sensitivity as an increase in MAP more than 5 mmHg and salt resistance as a change in MAP between -5 and 5 mmHg from low sodium to high sodium. Using this cutoff, 10.7% were ISS, 76.2% salt resistant, and 13.1% salt sensitive. Prevalence of ISS was similar between sexes and age groups ( P  > 0.05). However, ISS was more prevalent in those with normal BMI (15.8% ISS) compared with those with overweight BMI (0% ISS; P  < 0.01). Interestingly, classification of participants using a salt sensitivity index (ΔMAP/Δ urinary sodium excretion) categorized 21.4% as ISS, 48.8% salt resistant, and 29.8% salt sensitive. Overall, we found that the prevalence of ISS was 10.7% (5 mmHg cutoff) or 21.4% (salt sensitivity index), and that ISS was associated with lower BMI. These results highlight the importance of future work to understand the mechanisms of ISS and to standardize salt sensitivity assessment.

Sections du résumé

BACKGROUND
Salt sensitivity and inverse salt sensitivity [ISS; a reduction in blood pressure (BP) on a high sodium diet] are each associated with increased incidence of hypertension. The purpose of this analysis was to determine the prevalence of ISS in normotensive adults and whether ISS is associated with any demographic characteristic(s).
METHODS
Healthy normotensive, nonobese adults [ n  = 84; 43 women; age = 37 ± 13 years; baseline mean arterial pressure (MAP) = 89 ± 8 mmHg] participated in a controlled feeding study, consuming 7-day low-sodium (20 mmol sodium/day) and high-sodium (300 mmol sodium/day) diets. Twenty-four-hour ambulatory BP was assessed on the last day of each diet. ISS was defined as a reduction in 24-h MAP more than 5 mmHg, salt sensitivity as an increase in MAP more than 5 mmHg and salt resistance as a change in MAP between -5 and 5 mmHg from low sodium to high sodium.
RESULTS
Using this cutoff, 10.7% were ISS, 76.2% salt resistant, and 13.1% salt sensitive. Prevalence of ISS was similar between sexes and age groups ( P  > 0.05). However, ISS was more prevalent in those with normal BMI (15.8% ISS) compared with those with overweight BMI (0% ISS; P  < 0.01). Interestingly, classification of participants using a salt sensitivity index (ΔMAP/Δ urinary sodium excretion) categorized 21.4% as ISS, 48.8% salt resistant, and 29.8% salt sensitive.
CONCLUSION
Overall, we found that the prevalence of ISS was 10.7% (5 mmHg cutoff) or 21.4% (salt sensitivity index), and that ISS was associated with lower BMI. These results highlight the importance of future work to understand the mechanisms of ISS and to standardize salt sensitivity assessment.

Identifiants

pubmed: 36928305
doi: 10.1097/HJH.0000000000003413
pii: 00004872-202306000-00008
pmc: PMC10228636
mid: NIHMS1877988
doi:

Substances chimiques

Sodium Chloride, Dietary 0
Sodium Chloride 451W47IQ8X
Sodium 9NEZ333N27

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

934-940

Subventions

Organisme : NHLBI NIH HHS
ID : R01 HL104106
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL145055
Pays : United States

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Références

Murphy SL, Kochanek KD, Xu J, Arias E. Mortality in the United States, 2020 Key findings data from the National Vital Statistics System. 2020. NCHS Data Brief 2021; no 427 .
Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, et al. Heart Disease and Stroke Statistics-2022 Update: a report from the American Heart Association. Circulation 2022; 145:e153–e639.
Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary approaches to prevent and treat hypertension. Hypertension 2006; 47:296–308.
Elliott P, Stamler J, Nichols R, Dyer AR, Stamler R, Kesteloot H, et al. Intersalt revisited: further analyses of 24 h sodium excretion and blood pressure within and across populations. Intersalt Cooperative Research Group. BMJ 1996; 312:1249–1253.
Filippini T, Malavolti M, Whelton PK, Naska A, Orsini N, Vinceti M. Blood pressure effects of sodium reduction: dose-response meta-analysis of experimental studies. Circulation 2021; 143:1542–1567.
Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med 2001; 344:3–10.
He FJ, Tan M, Ma Y, MacGregor GA. Salt reduction to prevent hypertension and cardiovascular disease: JACC state-of-the-art review. J Am Coll Cardiol 2020; 75:632–647.
Longworth DL, Drayer JIM, Weber MA, Laragh JH. Divergent blood pressure responses during short-term sodium restriction in hypertension. Clin Pharmacol Ther 1980; 27:544–546.
Overlack A, Ruppert M, Kolloch R, Göbel B, Kraft K, Diehl J, et al. Divergent hemodynamic and hormonal responses to varying salt intake in normotensive subjects. Hypertension 1993; 22:331–338.
Weinberger MH. Salt sensitivity of blood pressure in humans. Hypertension 1996; 27:481–490.
He J, Huang J-F, Li C, Chen J, Lu X, Chen J-C, et al. Sodium sensitivity, sodium resistance, and incidence of hypertension: a longitudinal follow-up study of dietary sodium intervention. Hypertension 2021; 78:155–164.
Weinberger MH, Miller JZ, Luft FC, Grim CE, Fineberg NS. Definitions and characteristics of sodium sensitivity and blood pressure resistance. Hypertension 1986; 8:II-127–II-134.
Oh YS, Appel LJ, Galis ZS, Hafler DA, He J, Hernandez AL, et al. National Heart, Lung, and Blood Institute Working Group Report on Salt in Human Health and Sickness. Hypertension 2016; 68:281–288.
Weinberger MH, Fineberg NS, Fineberg SE, Weinberger M. Salt sensitivity pulse pressure and death in normal and hypertensive humans. Hypertension 2001; 37:429–432.
Morimoto A, Uzu T, Fujii T, Nishimura M, Kuroda S, Nakamura S, et al. Sodium sensitivity and cardiovascular events in patients with essential hypertension. The Lancet 1997; 350:1734–1737.
Bihorac A, Tezcan H, Özener Ç, Oktay A, Akoglu E. Association between salt sensitivity and target organ damage in essential hypertension. Am J Hypertens 2000; 13:864–872.
Weinberger MH, Fineberg NS. Sodium and volume sensitivity of blood pressure. Age and pressure change over time. Hypertension 1991; 18:67–71.
Barba G, Galletti F, Cappuccio FP, Siani A, Venezia A, Versiero M, et al. Incidence of hypertension in individuals with different blood pressure salt-sensitivity: results of a 15-year follow-up study. J Hypertens 2007; 25:1465–1471.
Falkner B, Kushner H. Interaction of sodium sensitivity and stress in young adults. Hypertension 1991; 17:I162–I165.
Faulkner JL, Belin de Chantemèle EJ. Female sex a major risk factor for salt-sensitive hypertension. Curr Hypertens Rep 2020; 22:99.
Rocchini AP, Key J, Bondie D, Chico R, Moorehead C, Katch V, et al. The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents. N Engl J Med 1989; 321:580–585.
Chen J, Gu D, Huang J, Rao DC, Jaquish CE, Hixson JE, et al. Metabolic syndrome and salt sensitivity of blood pressure in nondiabetic people in China: a dietary intervention study. Lancet 2009; 373:829–835.
Alderman MH, Lamport B. Moderate sodium restriction. Do the benefits justify the hazards? Am J Hypertens 1990; 3:499–504.
Overlack A, Ruppert M, Kolloch R, Kraft K, Stumpe KO. Age is a major determinant of the divergent blood pressure responses to varying salt intake in essential hypertension. Am J Hypertens 1995; 8:829–836.
Felder RA, White MJ, Williams SM, Jose PA. Diagnostic tools for hypertension and salt sensitivity testing. Curr Opin Nephrol Hypertens 2013; 22:65–76.
Castiglioni P, Parati G, Lazzeroni D, Bini M, Faini A, Brambilla L, et al. Hemodynamic and autonomic response to different salt intakes in normotensive individuals. J Am Heart Assoc 2016; 5:e003736.
Montasser ME, Douglas JA, lè ne Roy-Gagnon M-H, van Hout C v, Weir MR, Vogel R, et al. Determinants of blood pressure response to low-salt intake in a 422 healthy adult population. J Clin Hypertens (Greenwich) 2011; 13:795–800.
DuPont JJ, Greaney JL, Wenner MM, Lennon-Edwards SL, Sanders PW, Farquhar WB, et al. High dietary sodium intake impairs endothelium-dependent dilation in healthy salt-resistant humans. J Hypertens 2013; 31:530–536.
Brian MS, Dalpiaz A, Matthews EL, Lennon-Edwards S, Edwards DG, Farquhar WB. Dietary sodium and nocturnal blood pressure dipping in normotensive men and women. J Hum Hypertens 2017; 31:145–150.
Matthews EL, Brian MS, Ramick MG, Lennon-Edwards S, Edwards DG, Farquhar WB. High dietary sodium reduces brachial artery flow-mediated dilation in humans with salt-sensitive and salt-resistant blood pressure. J Appl Physiol 2015; 118:1510–1515.
Lennon-Edwards S, Ramick MG, Matthews EL, Brian MS, Farquhar WB, Edwards DG. Salt loading has a more deleterious effect on flow-mediated dilation in salt-resistant men than women. Nutr Metab Cardiovasc Dis 2014; 24:990–995.
Greaney JL, Dupont JJ, Lennon-Edwards SL, Sanders PW, Edwards DG, Farquhar WB. Dietary sodium loading impairs microvascular function independent of blood pressure in humans: role of oxidative stress. J Physiol 2012; 590:5519–5528.
Ramick MG, Brian MS, Matthews EL, Patik JC, Seals DR, Lennon SL, et al. Apocynin and Tempol ameliorate dietary sodium-induced declines in cutaneous microvascular function in salt-resistant humans. Am J Physiol Heart Circ Physiol 2019; 317:H97–H103.
Shenouda N, Ramick MG, Lennon SL, Farquhar WB, Edwards DG. High dietary sodium augments vascular tone and attenuates low-flow mediated constriction in salt-resistant adults. Eur J Appl Physiol 2020; 120:1383–1389.
Frankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc 2005; 105:775–789.
O’Brien E, Mee F, Coats A, Owens P, Petrie J, Padfield PL, et al. Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British Hypertension Society. BMJ 2000; 320:1128.
Schmidlin O, Forman Anthony Sebastian A, Morris RC. What initiates the pressor effect of salt in salt-sensitive humans? Hypertension 2007; 49:1032–1039.
Kurtz TW, DiCarlo SE, Pravenec M, Morris RC. An appraisal of methods recently recommended for testing salt sensitivity of blood pressure. J Am Heart Assoc 2017; 6:e005653.
Frame AA, Farquhar WB, Latulippe ME, McDonough AA, Wainford RD, Wynne BM. Moving the needle on hypertension. Nutr Today 2019; 54:248–256.
Felder RA, Gildea JJ, Xu P, Yue W, Armando I, Carey RM, et al. Inverse salt sensitivity of blood pressure: mechanisms and potential relevance for prevention of cardiovascular disease. Curr Hypertens Rep 2022; 24:361–374.
Carey RM, Schoeffel CD, Gildea JJ, Jones JE, McGrath HE, Gordon LN, et al. Salt sensitivity of blood pressure is associated with polymorphisms in the sodium-bicarbonate cotransporter. Hypertension 2012; 60:1359–1366.
Wójcik M, Kozioł-Kozakowska A. Obesity, sodium homeostasis, and arterial hypertension in children and adolescents. Nutrients 2021; 13:4032.
Engeli S, Böhnke J, Gorzelniak K, Janke J, Schling P, Bader M, et al. Weight loss and the renin-angiotensin-aldosterone system. Hypertension 2005; 45:356–362.
Gildea JJ, Xu P, Schiermeyer KA, Yue W, Carey RM, Jose PA, et al. Inverse salt sensitivity of blood pressure is associated with an increased renin-angiotensin system activity. Biomedicines 2022; 10:2811.
Rebholz CM, Gu D, Chen J, Huang J-F, Cao J, Chen J-C, et al. Physical activity reduces salt sensitivity of blood pressure: the Genetic Epidemiology Network of Salt Sensitivity study. Am J Epidemiol 2012; 176: (Suppl): S106–S113.
Pechère-Bertschi A, Maillard M, Stalder H, Brunner HR, Burnier M. Renal segmental tubular response to salt during the normal menstrual cycle. Kidney Int 2002; 61:425–431.

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