Clinical biochemical and haemodynamic correlates of sodium sensitivity in essential hypertension

Factors contributing to the blood pressure (BP) response to changes in dietary sodium intake were studied in 25 patients with essential hypertension (EH). Relevant clinical, biochemical and haemodynamic variables were measured after two weeks on a low sodium diet (LS, 50 mmol) and after two weeks on a high sodium diet (HS, 300 mmol). BP was significantly higher during HS. The difference in mean arterial pressure between HS and LS (delta MAP) was taken as a measure of sodium sensitivity. delta MAP was directly related to age, initial BP, plasma noradrenaline during HS and changes in forearm vascular resistance. It was indirectly related to plasma aldosterone during LS. No correlation was found with renin or with the excretion of urinary kallikrein. It is concluded that sodium sensitivity in EH is related to age and blood pressure and is predominantly mediated by changes in vascular resistance to which aldosterone and adrenergic mechanisms are likely to contribute.