From salt to hypertension, what is missed?

J Clin Hypertens (Greenwich). 2021 Dec;23(12):2033-2041. doi: 10.1111/jch.14402. Epub 2021 Nov 30.

Abstract

Excess salt intake is viewed as a major contributor to hypertension and cardiovascular disease, and dietary salt restriction is broadly recommended by public health guidelines. However, individuals can have widely varying physiological responses to salt intake, and a tailored approach to evaluation and intervention may be needed. The traditional sodium related concepts are challenging to assess clinically for two reasons: (1) spot and 24-hour urine sodium are frequently used to evaluate salt intake, but are more suitable for population study, and (2) some adverse effects of salt may be blood pressure-independent. In recent years, previously unknown mechanisms of sodium absorption and storage have been discovered. This review will outline the limitations of current methods to assess sodium balance and discuss new potential evaluation methods and treatment targets.

Keywords: absorption; excretion; hypertension; oral salt tolerance; sodium; storage.

Publication types

  • Review

MeSH terms

  • Blood Pressure
  • Diet, Sodium-Restricted
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Hypertension* / etiology
  • Sodium
  • Sodium Chloride, Dietary* / adverse effects

Substances

  • Sodium Chloride, Dietary
  • Sodium