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Hypertension. 2005;46:1321-1326
Published online before print October 24, 2005, doi: 10.1161/01.HYP.0000189183.50301.5c
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(Hypertension. 2005;46:1321.)
© 2005 American Heart Association, Inc.

Original Articles

Effects of Salt Sensitivity on Neural Cardiovascular Regulation in Essential Hypertension

Paolo Coruzzi; Gianfranco Parati; Lorenzo Brambilla; Valerio Brambilla; Massimo Gualerzi; Almerico Novarini; Paolo Castiglioni; Marco Di Rienzo

From the Department of Clinical Sciences (P.C., A.N.), University of Parma, Italy, and Fondazione Don C. Gnocchi ONLUS, Parma, Italy; Prevention and Rehabilitation Unit (L.B., V.B., M.G.,), Fondazione Don C. Gnocchi ONLUS, Parma, Italy; Department of Clinical Medicine, Prevention, and Applied Biotechnologies (G.P.), University of Milano-Bicocca and S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy; and Centro di Bioingegneria (P.C., M.D.), Fondazione Don C. Gnocchi ONLUS, Milan, Italy.

Correspondence to Marco Di Rienzo, Centro di Bioingegneria, Fondazione Don C. Gnocchi, via Capecelatro 66, I-20148 Milano, Italy. E-mail mdirienzo{at}cbi.dongnocchi.it

Salt-sensitive hypertensive subjects, as defined by conventional categorical classification, exhibit alterations of autonomic cardiovascular control. The aim of our study was to explore whether, in hypertensive subjects, the degree of autonomic dysfunction and the level of salt sensitivity are correlated even when the latter is only mildly elevated and displays under-threshold values. Salt sensitivity of 34 essential hypertensive subjects was assessed on a continuous basis by the salt sensitivity index after low- and high-sodium diet. Beat-by-beat finger blood pressure was recorded after each diet period. Autonomic cardiovascular control was evaluated by spectral analysis of blood pressure and pulse interval and by assessment of spontaneous baroreflex sensitivity (sequence technique). Salt sensitivity and baroreflex sensitivity showed a negative relationship during low and high sodium intake, starting from low values of the salt sensitivity index. All spectral indexes of pulse interval, except the ratio between low- and high-frequency powers, were inversely related to salt sensitivity index after high sodium intake. In subjects with lower salt sensitivity, baroreflex sensitivity and pulse interval power in the high-frequency band were higher after high sodium intake than after low sodium intake. In contrast, subjects with a higher salt sensitivity index showed lower values of baroreflex sensitivity and pulse interval power in the high-frequency band, uninfluenced by salt intake. Our results provide the first demonstration of an impairment of parasympathetic cardiac control in parallel with the increase in the degree of salt sensitivity, also in subjects who were not ranked as salt-sensitive by the conventional categorical classification.


Key Words: autonomic nervous system • heart rate • baroreflex • blood pressure • sodium, dietary


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