The role of salt in hypertension

There is considerable evidence that salt is an important cause of hypertension. Primitive societies who ingest little or no salt have no hypertension. Also when diets very low in salt such as the rice and fruit diet are given to hypertensive patients, the blood pressure often falls toward normal. Unfortunately, when diets only moderately low in sodium have been given only minor reductions in blood pressure occur. Salt-induced hypertension has been produced in both man and experimental animals. The basic cause of the hypertension is an inability of the kidney to excrete the increased salt. Hemodynamic changes then occur which raise the blood pressure and so excrete the excess salt by pressure diuresis. The ability to excrete salt at normal levels of blood pressure varies from one individual to another. Those who require a higher than normal blood pressure are said to be "salt-sensitive". Those who can excrete excess salt at normal levels of blood pressure are called "salt resistant". The difference may be due to an inherited defect in the kidney to excrete salt. In any event, salt sensitive hypertension is effectively controlled with the administration of diuretics.