Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 May;49(5):1032-9.
doi: 10.1161/HYPERTENSIONAHA.106.084640. Epub 2007 Mar 19.

What initiates the pressor effect of salt in salt-sensitive humans? Observations in normotensive blacks

Affiliations

What initiates the pressor effect of salt in salt-sensitive humans? Observations in normotensive blacks

Olga Schmidlin et al. Hypertension. 2007 May.

Abstract

We tested the traditional hypothesis that an abnormally enhanced renal reclamation of dietary NaCl alone initiates its pressor effect ("salt sensitivity"). Under metabolically controlled conditions, we grouped 23 normotensive blacks as either salt-sensitive (SS) or salt-resistant (SR), depending on whether or not dietary NaCl loading did or did not increase mean arterial blood pressure (MAP) by >or=5 mm Hg. We determined whether dietary NaCl loading induces greater increases in external Na(+) balance, plasma volume, and cardiac output in SS, compared with any in SR subjects, and differential changes in systemic vascular resistance (SVR) that could account for the pressor differences between SS and SR subjects. Using impedance cardiography, we measured cardiac output and SVR daily at 4-hour intervals throughout the last 3 days of a 7-day period of low NaCl intake (30 mmol per day) and throughout a subsequent 7-day period of NaCl loading (250 mmol per day). In the 11 SS subjects, compared with the 12 SR subjects, NaCl loading induced no greater increases in Na(+) balance, body weight, plasma volume, and cardiac output. Yet, from days 2 to 7 of NaCl loading, changes of MAP in SS diverged progressively from those in SR. From days 2 to 4, progressive increases of MAP in SS subjects reflected importantly impaired decreases of SVR, as judged from "normal" decreases of SVR in SR subjects. In SS and SR subjects combined, changes in both MAP and SVR on day 2 strongly predicted changes in MAP on day 7. In many normotensive blacks, vascular dysfunction is critical to the initiation of a pressor response to dietary NaCl.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

None

Figures

Figure 1
Figure 1. Time course of NaCl-induced changes in mean arterial pressure, MAP, systemic vascular resistance, SVR, cardiac output, CO, cumulative Na+ balance and change in body weight, BW, in salt-resistant (SR,▲) and salt-sensitive (SS, ●) subjects
Values are shown as percent change from baseline (average of day 5 through 7 of low-salt) except for Na+ balance which is measured in mmol. Values are means and 95% C.I. ⋆ P<0.01 and † P<0.05, respectively, compared to low-salt period. Responses of MAP and SVR to NaCl-loading differ significantly in SS vs SR from day 2. Responses of CO and BW do not differ between groups. Net cumulative Na+ balance is slightly but significantly more positive in SR than in SS by day 7.
Figure 2
Figure 2. NaCl-induced changes in serum protein concentration (A) and hematocrit values (B)
In salt-resistant (SR, ▲) and salt-sensitive (SS, ●) subjects serum protein concentration and hematocrit values are significantly and similarly reduced by day 2 of NaCl-loading and remain so by day 7, indicating a persistent significant and similar NaCl-induced increase in plasma volume in both groups. ⋆ P<0.05, respectively, compared to low-salt period.
Figure 3
Figure 3. Relationship between NaCl-induced changes in average MAP of days 5, 6 and 7 of NaCl-loading and initial NaCl-induced changes in MAP and SVR
(A) ΔMAP, day 1 at 6PM; (B) ΔMAP, day 2, 24-hr average; (C) ΔSVR, day 2, 24-hr average. The initial NaCl-induced changes in MAP and SVR are highly predictive of NaCl-induced changes in average MAP of days 5, 6 and 7. Changes in MAP at 6PM in panel (A) are relative to the average values measured at this time during the 3-day period preceding NaCl-loading; changes in MAP and SVR in panels (B) and (C) are relative to the 24-hr mean values measured during the 3-day period preceding NaCl-loading.
Figure 4
Figure 4. Relationship between NaCl-induced changes in CO and SVR in SR and SS
Values are averages of days 5, 6 and 7 of NaCl-loading expressed as % change form baseline. SVR was above baseline in all SS (●) and below baseline in most SR (▲). In two of the SS the increase in SVR was accompanied by a slightly greater increase in CO and in another two SVR and CO were increased similarly. In SR, but not in SS, changes in CO were inversely related to changes in SVR.

References

    1. Weinberger MH, Fineberg NS. Sodium and volume sensitivity of blood pressure: age and pressure change over time. Hypertension. 1991;18:67–71. - PubMed
    1. Weinberger MH, Fineberg NS, Fineberg SE, Weinberger M. Salt Sensitivity, pulse pressure, and death in normal and hypertensive humans. Hypertension. 2001;37:429–432. - PubMed
    1. Weinberger MH. Salt sensitivity of blood pressure in humans. Hypertension. 1996;27:481–490. - PubMed
    1. Guyton AC. Blood pressure control--special role of the kidneys and body fluids. Science. 1991;252:1813–1816. - PubMed
    1. Lifton RP, Gharavi AG, Geller DS. Molecular mechanisms of human hypertension. Cell. 2001;104:545–556. - PubMed

Publication types

Substances