This Article Full Text Full Text (PDF) All Versions of this Article: 44/1/22    most recent 01.HYP.0000132768.19056.33v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bagrov, A. Y. Articles by Lakatta, E. G. Search for Related Content PubMed PubMed Citation Articles by Bagrov, A. Y. Articles by Lakatta, E. G. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Dietary Sodium High Blood Pressure Related Collections Remodeling Primary prevention ACE/Angiotension receptors Smooth muscle proliferation and differentiation Peripheral vascular disease Clinical Studies Endothelium/vascular type/nitric oxide

(Hypertension. 2004;44:22.)
© 2004 American Heart Association, Inc.

Editorial Commentaries

The Dietary Sodium-Blood Pressure Plot "Stiffens"

From the Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Md.

Correspondence to E.G. Lakatta, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 5600 Nathan Shock Dr, Baltimore, MD 21224. E-mail LakattaE@grc.nia.nih.gov

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Nearly 50% of our population by 65 years of age has a systolic pressure within a "risky" range, that is, has predominantly systolic hypertension (PSH),¹ attributable, in part, to a reduction in large artery compliance because of an increased stiffness of the arterial wall. For a given pattern of left ventricular ejection, arterial stiffening reduces diastolic pressure and increases pulse pressure. Although increased arterial stiffness elevates pulse pressure, it is not itself sufficient to raise systolic pressure to hypertensive levels, unless accompanied by an increase in stroke volume or peripheral vascular resistance (PVR).² Whereas the former is not increased in older persons with PSH, the latter is higher (by 15% on average) than in age-matched normotensive persons.³ This mild-moderate elevation of PVR is usually unrecognized because it is not routinely assessed. The increased large artery stiffness that accompanies PSH precedes the elevation of arterial pressure to clinically defined hypertensive values,⁴ giving rise to the notion that this form of hypertension, at least in part, is a disease of the arterial wall. Moreover, elevated pulse wave velocity, an index of arterial stiffness, and reduced total systemic compliance, assessed by stroke volume/pulse pressure, are themselves independent predictors of future cardiovascular events, even after accounting for the effect of the concomitant increase in blood pressure.^5,6

There is substantial evidence to indicate that the NaCl dependence of arterial pressure increases with advancing age and that this age effect is exaggerated in older hypertensive patients.⁷ In this issue of Hypertension, Gates et al⁸ add . . . [Full Text of this Article]

This article has been cited by other articles:

				G. Bianchi Genetic variations of tubular sodium reabsorption leading to "primary" hypertension: from gene polymorphism to clinical symptoms Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2005; 289(6): R1536 - R1549. [Abstract] [Full Text] [PDF]

				S. J. Zieman, V. Melenovsky, and D. A. Kass Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness Arterioscler Thromb Vasc Biol, May 1, 2005; 25(5): 932 - 943. [Abstract] [Full Text] [PDF]

				J. D. Neaton and L. H. Kuller Diuretics Are Color Blind JAMA, April 6, 2005; 293(13): 1663 - 1666. [Full Text] [PDF]

				S. S. Franklin Arterial Stiffness and Hypertension: A Two-Way Street? Hypertension, March 1, 2005; 45(3): 349 - 351. [Full Text] [PDF]