Insulin resistance and salt sensitivity. A renal hemodynamic abnormality?

Salt has been a staple of the human diet for millennia and has long been known to be a critical factor in blood pressure regulation. The threshold and precise relationship between dietary salt and blood pressure has not been established. Moreover, there is significant variability in blood pressure responses to changes in dietary salt between patients. This variation approximates a Gaussian distribution, is highly reproducible in individual patients, and is persistent over time. Recent clinical studies have demonstrated that blood pressure, salt sensitivity and insulin resistance frequently coexist. It is likely that neurohormonal systems, particularly the sympathetic nervous system and the renin-angiotensin system, play a critical role in explaining the interrelationship of salt sensitivity, insulin resistance, and an impaired pressure-natriuresis response.