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Female Sex, a Major Risk Factor for Salt-Sensitive Hypertension

  • Inflammation and Cardiovascular Diseases (A Kirabo, Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

High dietary salt is a significant contributor to essential hypertension in clinical populations. However, although clinical studies indicate a higher prevalence of salt sensitivity in women over men, knowledge of salt-sensitive mechanisms is largely restricted to males, and female-specific mechanisms are presently being elucidated.

Recent Findings

Male-specific mechanisms of salt-sensitive hypertension are well published and predominantly appear to involve dysfunctional renal physiology. However, emerging novel evidence indicates that aldosterone production is sex-specifically heightened in salt-sensitive hypertensive women and female rodent models, which may be regulated by intra-adrenal renin-angiotensin system activation and sex hormone receptors. In addition, new evidence that young females endogenously express higher levels of endothelial mineralocorticoid receptors (MRs) and that endothelial MR is a crucial mediator of endothelial dysfunction in females indicates that the aldosterone-endothelial MR activation pathway is a novel mediator of salt-sensitive hypertension.

Summary

Heightened aldosterone levels and endothelial MR expression provide a 2-fold sex-specific mechanism that may underlie the pathology of salt-sensitive hypertension in women. This hypothesis indicates that MR antagonists may be a preferential treatment for premenopausal women diagnosed with salt-sensitive hypertension.

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Funding

This work has been supported by NIH R01HL130301, R01HL147639, R01HL155265 and AHA 19EIA34760167 to E.JBdC and 1 K99 HL146948-01 to JLF.

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Authors and Affiliations

  1. Vascular Biology Center, Medical College of Georgia at Augusta University, 1460 Laney Walker Blvd., Augusta, GA, 30912, USA

    Jessica L. Faulkner & Eric J. Belin de Chantemèle

  2. Department of Medicine (Cardiology), Medical College of Georgia at Augusta University, 1460 Laney Walker Blvd., Augusta, GA, 30912, USA

    Eric J. Belin de Chantemèle

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Faulkner, J.L., Belin de Chantemèle, E.J. Female Sex, a Major Risk Factor for Salt-Sensitive Hypertension. Curr Hypertens Rep 22, 99 (2020). https://doi.org/10.1007/s11906-020-01113-6

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