Effects of age and sex on sodium chloride sensitivity: association with plasma renin activity

The mechanism by which excessive NaCl intake raises blood pressure has not been fully clarified. The present study was undertaken in 87 Japanese inpatients with essential hypertension to investigate the interrelation among effects of age, sex and the renin-angiotensin system on NaCl sensitivity. After ingesting a regular NaCl diet (170 mmol/day) for one week, subjects were placed sequentially on a week of low NaCl diet (50 mmol/day) and a week of high NaCl diet (340 mmol/day). NaCl sensitivity defined as the difference in mean blood pressure between the low and high NaCl diets did not differ between genders. NaCl sensitivity was positively correlated with age and the change in PRA. The fall in PRA after NaCl loading was significantly smaller in women than in men. By multiple regression analysis, age and the change in PRA independently contributed to the change in mean blood pressure. Furthermore, the interaction between sex and the change in PRA was selected as a statistically significant variable. In conclusion, NaCl sensitivity of blood pressure is independently associated with age and the inadequate suppression of the renin-angiotensin system. Because the contribution of the change in PRA to NaCl sensitivity was greater in women than in men, the mechanism of blood pressure elevation after NaCl loading may differ between genders.