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The Influence of Dietary Salt Beyond Blood Pressure

  • Blood Pressure Monitoring and Management (J Cockcroft, Section Editor)
  • Published:
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Abstract

Purpose of Review

Excess sodium from dietary salt (NaCl) is linked to elevations in blood pressure (BP). However, salt sensitivity of BP varies widely between individuals and there are data suggesting that salt adversely affects target organs, irrespective of BP.

Recent Findings

High dietary salt has been shown to adversely affect the vasculature, heart, kidneys, skin, brain, and bone. Common mediators of the target organ dysfunction include heightened inflammation and oxidative stress. These physiological alterations may contribute to disease development over time. Despite the adverse effects of salt on BP and several organ systems, there is controversy surrounding lower salt intakes and cardiovascular outcomes.

Summary

Our goal here is to review the physiology contributing to BP-independent effects of salt and address the controversy around lower salt intakes and cardiovascular outcomes. We will also address the importance of background diet in modulating the effects of dietary salt.

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Abbreviations

BP:

Blood pressure

BMC:

Bone mineral content

BMD:

Bone mineral density

CV:

Cardiovascular

CSF:

Cerebrospinal fluid

CRIC :

Chronic Renal Insufficiency Cohort

ENaC:

Epithelial sodium channel

DASH:

Dietary approaches to stop hypertension

LV:

Left ventricle

NO:

Nitric oxide

O2 - :

Superoxide

ONOO- :

Peroxynitrate

OVLT:

Organum vasculosum of the lamina terminalis

PURE:

Prospective Urban Rural Epidemiology

RCTs:

Randomized clinical trials

RAAS:

Renin angiotensin aldosterone system

RVLM:

Rostral ventrolateral medulla

Na+ :

Sodium

SOD:

Superoxide dismutase

SNA:

Sympathetic nerve activity

TOHP:

Trials of Hypertension Prevention

VEGF:

Vascular endothelial growth factor

24hU-Na+ :

24-h urinary sodium excretion

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Funding

The authors have been supported by the following grants which have also contributed to some of the original work cited here: NIH P20 GM113125 (DGE); NIH R01 HL128388 (WBF); NIH R01 HL104106 (WBF and DGE); AHA 18POST34060020 (ATR).

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  1. Department of Kinesiology and Applied Physiology, University of Delaware, 540 South College Avenue, 201M, Newark, DE, 19713, USA

    Austin T. Robinson, David G. Edwards & William B. Farquhar

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Robinson, A.T., Edwards, D.G. & Farquhar, W.B. The Influence of Dietary Salt Beyond Blood Pressure. Curr Hypertens Rep 21, 42 (2019). https://doi.org/10.1007/s11906-019-0948-5

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