Salt, Hypertension and Cardiovascular Disease: the Connection
Abstract
Hypertension (HT) the most important risk factor of cardiovascular disease (CVD), is a heterogeneous disease; the underlying cause is unknown. Genetic back-ground and environmental influences are both involved. The most important environmental fac-tors are physical inactivity and dietary factors, particularly salt and potassium intake.There is a relationship between Blood Pressure (BP) and natriuresis which maintains sodium bal-ance and extra cellular fluid volume. An impaired ability of the kidney to excrete sodium, requires an increase in BP to increase natriuresis and correct sodium balance resulting in HT. Much evidence suggests, that in those who develops high BP, there is an underlying defect in the ability of the kidney to excrete salt and that the greater compensatory response required to restore sodium balance is the cause for the increase in BP.
Epidemiological, mi-gration, intervention, treatment, genetic and animal studies have shown that dietary salt (sodium chlo-ride) plays an important role in BP regulation. The INTERSALT study, the EPIC-Norfolk study and many other studies have shown that BP was higher among subjects with a high sodium intake.
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References
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He FJ, Markandu ND, Sagnella GA, de Wardener HE, MacGregor GM. Plasma Sodium. Ignored and underestimated. Hypertension. 2005; 45: 98-102.
He FJ, MacGregor GA. Reducing population salt intake world-wide: From evidence to implementation. Prog Cardovasc Dis. 2010; 52: 363-82.
He FJ, Marciniak M, Visagie E, et al. Effect of modest salt reduc-tion on blood pressure, urinary albumin, and pulse wave velocity in white, black, and Asian mild hypertensives. Hypertension. 2009; 54: 482-8.
Karpanen H, Mervaala E. Sodium Intake and Hypertension. Prog Cardiovasc Dis. 2006; 49: 59-75.
He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure : a meta-analysis of randomized trials. Im-plication for public health. J Human Hypertension. 2002;16: 761-70.
Blacher J, Safar ME. Large–artery stiffness, hypertension and cardiovascular risk in older patients. Nat Clin Pract Cardio-vasc Med. 2005; 2: 451-5.
Frohlich ED. Ventricular remodeling / fibrosis, renal arterial brachytherapy, collagen crosslink breakers, salt, and thera-peutic adherence. Curr Op Cardiol. 2004; 19: 323-5.
Frohlich ED. The Salt Conundrum: A hypothesis. Hyperten-sion. 2007; 50: 161-6.
Li J, White J, Guo L, et al. Salt inactivates Endothelial Nitric Oxide Synthase in endothelial cells. J Nutr. 2009;139: 447-51.
Oberleithner H, Riethmuller C, Schiller H, et al. Plasma sodium stiffens vascular endothelium and reduces nitric oxide release. PNAS. 2007; 104: 16281-6.
Dickinson KM, Keogh JB, Clifton PM. Effects of low-salt diet on flow-mediated dilation in humans. Am J Clin Nutr. 2009; 89: 485-90.
Kimura G, Dohi Y, Fukuda M. Salt sensitivity and circadian rhythm of blood pressure:the keys to connect CKD with Car-diovascular events. Hypertension Research. 2010; 33: 515-20.
Strazzulo P, D’Elia L, Kandala NB, Cappucio FP. Salt intake, stroke and cardiovascular disease : meta analysis of prospec-tive studies. BMJ. 2009; 339: 1-9.
Cook NR et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes : observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007; 334: 885.
He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension. 2003; 42: 1093-9.
Ritz E. Salt and Hypertension. Nephrology. 2010; 15: 49-52.
He FJ, Markandu ND, Sagnella GA, de Wardener HE, MacGregor GM. Plasma Sodium. Ignored and underestimated. Hypertension. 2005; 45: 98-102.
He FJ, MacGregor GA. Reducing population salt intake world-wide: From evidence to implementation. Prog Cardovasc Dis. 2010; 52: 363-82.
He FJ, Marciniak M, Visagie E, et al. Effect of modest salt reduc-tion on blood pressure, urinary albumin, and pulse wave velocity in white, black, and Asian mild hypertensives. Hypertension. 2009; 54: 482-8.
Karpanen H, Mervaala E. Sodium Intake and Hypertension. Prog Cardiovasc Dis. 2006; 49: 59-75.
He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure : a meta-analysis of randomized trials. Im-plication for public health. J Human Hypertension. 2002;16: 761-70.
Blacher J, Safar ME. Large–artery stiffness, hypertension and cardiovascular risk in older patients. Nat Clin Pract Cardio-vasc Med. 2005; 2: 451-5.
Frohlich ED. Ventricular remodeling / fibrosis, renal arterial brachytherapy, collagen crosslink breakers, salt, and thera-peutic adherence. Curr Op Cardiol. 2004; 19: 323-5.
Frohlich ED. The Salt Conundrum: A hypothesis. Hyperten-sion. 2007; 50: 161-6.
Li J, White J, Guo L, et al. Salt inactivates Endothelial Nitric Oxide Synthase in endothelial cells. J Nutr. 2009;139: 447-51.
Oberleithner H, Riethmuller C, Schiller H, et al. Plasma sodium stiffens vascular endothelium and reduces nitric oxide release. PNAS. 2007; 104: 16281-6.
Dickinson KM, Keogh JB, Clifton PM. Effects of low-salt diet on flow-mediated dilation in humans. Am J Clin Nutr. 2009; 89: 485-90.
Kimura G, Dohi Y, Fukuda M. Salt sensitivity and circadian rhythm of blood pressure:the keys to connect CKD with Car-diovascular events. Hypertension Research. 2010; 33: 515-20.
Strazzulo P, D’Elia L, Kandala NB, Cappucio FP. Salt intake, stroke and cardiovascular disease : meta analysis of prospec-tive studies. BMJ. 2009; 339: 1-9.
Cook NR et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes : observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007; 334: 885.
He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension. 2003; 42: 1093-9.
Ritz E. Salt and Hypertension. Nephrology. 2010; 15: 49-52.
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How to Cite
Soenarta, A. (1). Salt, Hypertension and Cardiovascular Disease: the Connection. Indonesian Journal of Cardiology, 32(2), 69-70. https://doi.org/10.30701/ijc.v32i2.101
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