Blood pressure response to sodium in children and adolescents

The predisposition to primary hypertension is composed of genetic factors, and aberrant mechanisms leading to the clinical expression of hypertension may be operational in children and adolescents. Dietary composition may play a role in the expression of hypertension. The effects of diet on blood pressure in the young may be indirect, reflecting the relation of diet with growth and body composition. Alternatively, there may be a direct effect of a specific dietary factor, such as sodium, on mechanisms regulating blood pressure. The average daily sodium intake by children and adolescents exceeds recommended amounts. Despite the high sodium intake among children, there are few data showing that decreasing sodium intake lowers blood pressure. Children who do express blood pressure sensitivity to sodium intake also have related risk factors for cardiovascular disease such as a positive family history or obesity. Prospective data are needed in children with characteristic risk factors to determine whether sodium intake contributes to the pathogenesis of hypertension and whether this course can be modified by alterations in diet.