Sodium Intake and Essential Hypertension
ثبت نشده
چکیده
This review briefly considers the hypothesis that a generous dietary sodium intake contributes to the development or maintenance of essential hypertension. Three lines of evidence are presented that are not mutually exclusive. Epidemiological studies examining sodium intake, prevalence of hypertension, and increases of blood pressure with age provide circumstantial support for the concept that hypertension is related to sodium intake. Analyses of cellular electrolyte transport suggest that hypertensives and their relatives are at a disadvantage with respect to extruding sodium from cells. A conceptual framework indicates that blood pressure is determined by a balance between the natriuretic effect of increased blood pressure and the pressor effect of sodium retention. Clinical studies in humans support the sodium hypothesis. The kidney's ability to excrete sodium and its sodium regulatory system are genetically determined. In hypertensive humans, blood pressure is directly correlated with total body and exchangeable sodium, a relationship that increases with age. Groups at risk for hypertension excrete sodium less well than those at less risk. Yet both hypertensives and normotensives exhibit heterogeneous blood pressure responses when sodium-loaded or -depleted. It has not been shown that sodium restriction will prevent the development of hypertension in normal individuals; however, it is clear that sodium restriction is an important aspect of management. In three prospective randomized controlled trials, practical sodium restriction lowered blood pressure by 8 mm Hg. Such a decrease would lower cardiovascular morbidity by 10% to 15%. Were means available to detect "salt-sensitive" hypertensives, sodium restriction could be conducted in a more appropriate fashion.(Hypertension 4 (supp III): 111-14—III-19, 1982)
منابع مشابه
[Plasma norepinephrine variation with dietary sodium intake in normotensive subjects and patients with essential hypertension].
Sympathetic nervous system may play an important role in the pathogenesis of essential hypertension. The present study was undertaken to evaluate the interaction between sodium intake and sympathetic nervous activity in the patients with essential hypertension. Plasma and urinary catecholamines (CA) were measured in 38 hypertensive patients (WHO 1-2 stage) and 24 age-matched normal subjects on ...
متن کاملPlasma norepinephrine and dietary sodium intake in normal subjects and patients with essential hypertension.
To evaluate the relationship between sodium intake and the activity of the sympathetic nervous system in patients with essential hypertension, plasma catecholamine levels were measured in 49 essential hypertensive patients and 38 age-matched normal subjects under regular-, high-, and low-sodium diets (mean 24-hour sodium excretions; 116 +/- 8, 267 +/- 29, 31 +/- 7 mEq/day, respectively). The le...
متن کاملSodium and Potassium Intake and Blood Pressure
There is increasing circumstantial evidence that the very high sodium diet combined with low potassium intake that most Western communities now eat may be, at least in part, responsible for the prevalence of high blood pressure. This circumstantial evidence combined with animal evidence has been considered sufficient in some countries to make a general recommendation to reduce sodium intake. If...
متن کاملUrinary kallikrein excretion in hypertensive man. Relationships to sodium intake and sodium-retaining steroids.
Urinary kallikrein excretion was measured by a radiochemical esterolytic assay in patients with essential hypertension or primary aldosteronism. Patients with essential hypertension excreted significantly less (P < 0.001) kallikrein than did normal subjects when they were allowed an ad libitum sodium intake or given 259 mEq sodium/day. When sodium intake was changed from ad libitum to 9 mEq/day...
متن کاملA Determinant of Cardiac Involvement in Essential Hypertension
Because a given increase in afterload does not consistently produce the same degree of left ventricular hypertrophy, we evaluated several clinical, hemodynamic, and endocrine factors that are prone to modify the adaptation of left ventricular structure in patients with mild essential hypertension (World Health Organization stages I or II). Dietary salt intake assessed by sodium excretion over 2...
متن کاملSodium intake and essential hypertension.
This review briefly considers the hypothesis that a generous dietary sodium intake contributes to the development or maintenance of essential hypertension. Three lines of evidence are presented that are not mutually exclusive. Epidemiological studies examining sodium intake, prevalence of hypertension, and increases of blood pressure with age provide circumstantial support for the concept that ...
متن کامل