Hypertension, Vol 18, 67-71, Copyright © 1991 by American Heart Association
MH Weinberger and NS Fineberg
Salt sensitivity has been implicated in the age-related increase in blood
pressure. We studied the reproducibility of a rapid method for assessing
sodium sensitivity and resistance of blood pressure as well as the effect
of age on this phenomenon. Blood pressure after volume expansion with 2 l
intravenous saline (0.9%) over 4 hours was compared with that after 1 day
of 10 mmol sodium chloride intake and 3 and 40 mg oral doses of furosemide.
Normal and hypertensive subjects (n = 28) were studied twice within a year.
Cross-sectional observations of the effect of age were made from studies in
230 hypertensive and 430 normotensive subjects. Longitudinal observations
of blood pressure change over time were made 10 or more years after
categorization of sodium responsivity in 31 subjects. The blood pressure
response was reproducible in 28 subjects studied twice (r = 0.56, p less
than 0.002). Four subjects changed salt-responsiveness status and six were
indeterminate on restudy. Sodium sensitivity of blood pressure increased
significantly with increasing age in the entire population (n = 660, r =
-0.38, p less than 0.001). The relation was more striking in hypertensive
subjects (n = 230, r = -0.31, p less than 0.001) in whom a progressive
increase in salt sensitivity with decades was seen than in the normotensive
group (n = 430, r = -0.19, p less than 0.01) in whom salt sensitivity was
not observed until the sixth decade. Salt- sensitive subjects had a
significantly greater increase in systolic (p less than 0.001) and
diastolic (p less than 0.01) pressure over time than those who were
salt-resistant. Salt sensitivity is a reproducible phenomenon that is
related to the age-associated increase in blood pressure characteristic of
industrialized societies. In addition, salt sensitivity can be shown to be
a predictor of subsequent, age-related blood pressure increase.
ARTICLES
Sodium and volume sensitivity of blood pressure. Age and pressure change over time
Hypertension Research Center, Indiana University School of Medicine, Indianapolis 46202-5111.
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