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Sodium-selective salt sensitivity: its occurrence in blacks.

Olga Schmidlin1, Alex Forman, Anthony Sebastian

  • 1Division of Nephrology, Department of Medicine, University of California San Francisco, 1291 Moffitt Hospital, CA 94143-0126, USA.

Hypertension (Dallas, Tex. : 1979)
|October 17, 2007
PubMed
Summary
This summary is machine-generated.

Dietary sodium chloride (NaCl) has a pressor effect independent of fluid volume expansion. This "sodium-selective" salt sensitivity impacts blood pressure and kidney function in salt-sensitive individuals.

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Area of Science:

  • Cardiovascular Physiology
  • Renal Physiology
  • Nutritional Science

Background:

  • Dietary salt intake is a major determinant of blood pressure.
  • The mechanisms by which sodium chloride (NaCl) influences blood pressure are complex and not fully understood.
  • It is unclear whether the sodium ion (Na(+)) component of NaCl has pressor effects independent of chloride (Cl(-)) and plasma volume expansion.

Purpose of the Study:

  • To test the hypothesis that the Na(+) component of dietary NaCl has a pressor effect separate from its osmotic role in plasma volume expansion.
  • To investigate the independent pressor and renal effects of Na(+) in salt-sensitive and salt-resistant individuals.

Main Methods:

  • A study involving 35 mostly normotensive Black individuals on a low-NaCl diet.
  • Oral sodium loading with either sodium bicarbonate (NaHCO(3)) or NaCl (250 mmol/d) over 3 weeks.
  • Measurement of mean arterial pressure, hematocrit (for plasma volume), plasma Na(+) concentration, renal blood flow, and renal vascular resistance.

Main Results:

  • In salt-sensitive subjects, both NaHCO(3) and NaCl loading increased mean arterial pressure, with NaCl having a greater effect.
  • Plasma volume expansion was similar with NaCl in both salt-sensitive and salt-resistant groups, but less with NaHCO(3).
  • Salt-sensitive individuals showed decreased renal blood flow and increased renal vascular resistance with both NaHCO(3) and NaCl, indicating sodium-selective effects.

Conclusions:

  • The Na(+) component of NaCl can exert pressor and renal vasoconstrictive effects independently of plasma volume expansion.
  • This study establishes "sodium-selective" salt sensitivity, highlighting the direct impact of Na(+) on blood pressure regulation.
  • Findings suggest that Na(+) alone, beyond its osmotic contribution, plays a significant role in hypertension pathogenesis.