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Inverse salt sensitivity: an independent risk factor for cardiovascular damage in essential hypertension

Ermira Cuka1, Marco Simonini1, Chiara Lanzani1

  • 1Chair of Nephrology, Vita-Salute University San Raffaele and Genomics of Renal Diseases and Hypertension Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Journal of Hypertension
|July 26, 2022
PubMed

Insights

Salt sensitivity and inverse salt sensitivity are significant risk factors for cardiovascular events in hypertensive patients. The acute saline test can predict cardiovascular damage, especially in inverse salt-sensitive individuals.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Salt sensitivity is a known risk factor for cardiovascular disease and mortality.
  • Its predictive value for cardiovascular events and target organ damage in essential hypertension requires further investigation.

Purpose of the Study:

  • To evaluate the predictive value of salt sensitivity phenotypes for cardiovascular events and target organ damage in essential hypertensive patients.
  • To assess the association between salt sensitivity and cardiovascular outcomes.

Main Methods:

  • Recruited 844 naive hypertensive patients for an acute saline test to classify them into salt-resistant (SR), salt-sensitive (SS), or inverse salt-sensitive (ISS) phenotypes.
  • Followed up 61 patients for a median of 16 years, monitoring blood pressure and target organ damage (TOD).
  • Developed a clinical score for TOD based on hypertensive heart disease, cerebrovascular damage, microalbuminuria, and vascular events.

Main Results:

  • Salt-sensitive (SS) and inverse salt-sensitive (ISS) patients had significantly higher rates of cardiovascular events compared to salt-resistant (SR) patients.
  • The relative risk of CV events was 12.67 times higher for SS and 5.94 times higher for ISS patients than for SR patients.
  • Moderate to severe target organ damage was 10-fold higher in SS and over 15-fold higher in ISS patients compared to SR patients.

Conclusions:

  • Salt sensitivity and inverse salt sensitivity are equivalent risk factors for cardiovascular events.
  • The acute saline test is a valuable tool for predicting cardiovascular damage, particularly in newly identified inverse salt-sensitive individuals.
Abstract

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