Abstract
The role of sodium in the pathogenesis of hypertension is not agreed. It is likely that excess dietary sodium or excessive retention of sodium is capable of raising blood pressure in some circumstances in man. In Conn’s syndrome, for example, the body content of sodium is abnormally increased, the increase is positively related to arterial pressure1, and both abnormalities are corrected by surgical removal of the causative tumour1. It is also well recognized that increased dietary sodium can raise blood pressure in patients with chronic renal failure2. However, in essential hypertension the role of sodium is much less certain. Although blood pressure and dietary sodium are higher and essential hypertension is commoner in ‘civilized’ than in primitive societies, within a civilized society the essential hypertensives do not, as a rule, eat or excrete more sodium than normal individuals . Nor do patients with essential hypertension have an excess of body sodium and yet amongst such patients arterial pressure and body sodium are positively related, while normal subjects show no correlation of arterial pressure and body sodium4,5 (Figure 1).
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References
C. Beretta-Piccoli, D. L. Davies, J. J. Brown, J. B. Ferriss, R. Fraser, A. F. Lever, J. J. Morton, and J. I. S. Robertson, The relation of arterial pressure with plasma and body electrolytes is similar in Conn’s syndrome and essential hypertension, Clin.Sci. (in press).
F. C. Husted, K. D. Nolph, and J. F. Maher, NaHCO3 and NaCl tolerance in chronic renal failure, J.Clin.Invest. 56:414 (1975).
F. O. Simpson, Salt and hypertension: a sceptical review of the evidence, Clin.Sci. 57:463s (1979).
A. F. Lever, C. Beretta-Piccoli, J. J. Brown, D. L. Davies, R. Fraser, and J. I. S. Robertson, Sodium and potassium in essential hypertension, Brit.Med.J. 283:463 (1981).
C. Beretta-Piccoli, D. L. Davies, K. Boddy, J. J. Brown, A. M. M. Cumming, B. W. East, R. Fraser, A. F. Lever, P. L. Padfield, P. F. Semple, J. I. S. Robertson, P. Weidmann, and E. D. Williams, Relation of body sodium, body potassium, plasma potassium with arterial pressure in essential hypertension, Clin.Sci. (in press).
G. W. Pickering, Salt intake and blood pressure, Cardiovasc.Revs.& Reports. 1:13 (1980).
L. K. Dahl, Salt intake and hypertension, in: “Hypertension, Pathophysiology and Treatment,” J. Genest, E. Koiw, and O. Kuchel, eds., McGraw-Hill Book Company, New York, 548 (1977).
J. M. Sullivan, T. E. Ratts, J. C. Taylor, D. H. Kraus, B. R. Barton, D. R. Patrick, and S. W. Reed, Hemodynamic effects of dietary sodium in man, Hypertension 2:506 (1980).
T. Morton, W. Adam, A. Gillies, M. Wilson, G. Morgan, and S. Carney, Hypertension treated by salt restriction, Lancet 1:227 (1978).
G. A. MacGregor, F. E. Best, J. M. Cam, N. D. Markandu, D. M. Elder, G. A. Sagnella, M. Squires, Double blind randomised crossover trial of moderate sodium restriction in essential hypertension, Lancet 1:251 (1982).
Veterans Administration Cooperative Study Group on antihypertensive agents, Effects of treatment on morbidity in hyper tension: results in patients with diastolic blood pressures averaging 115 through 129 mmHg, JAMA 202:1228 (1967).
MRC Working Party on mild to moderate hypertension. Randomized control trial of treatment for mild hypertension: design and pilot trial, Brit.Med.J. 1:1437 (1977).
R. Reader, The Australian therapeutic trial in mild hypertension, Report by the Management Committee, Lancet 1:1261 (1980).
Select Committee on Nutrition and Human Needs, “Dietary goals for the United States,” United States Senate, Chairman, G. McGovern, U.S. Government Printing Office, 49 (1977).
Report of a Select Committee of Food and Drug Administration, “Evaluation of the health aspects of sodium chloride and potassium chloride as food ingredients,” Washington DC (1979).
D. L. Davies, and J. W. K. Robertson, Simultaneous measurement of total exchangeable potassium and sodium using 24K and 24Na, Metabolism 22:133 (1973).
K. Boddy, J. J. Brown, D. L. Davies, A. Elliot, I. Harvey, J. K. Haywood, I. Holloway, A. F. Lever, J. I. S. Robertson, and E. D. Williams, Concurrent estimation of total body and exchangeable body sodium in hypertension, Clin.Sci.& Mol.Med. 54:187 (1978).
Z. Zadik, B. P. Hamilton, and A. A. Kowarski, Integrated concentration of epinephrine and norepinephrine in normal subjects and in patients with mild essential hypertension, J.Clin.Endocrinol.& Metab. 50:842 (1980).
I. J. Kopin, D. S. Goldstein, G. Z. Feuerstein, The sympathetic nervous system and hypertension, in: “Frontiers in Hypertension Research,” J. H. Laragh, F. R. Buhler, D. W. Seldin, eds., Springer-Verlag, New York 283 (1981).
L. K. Dahl, B. G. Stall, and G. C. Cotzias, Metabolic effects of marked sodium restriction in hypertensive patients: changes in total exchangeable sodium and potassium, J.Clin. Invest. 33:1397 (1954).
V. P. Dole, L. K. Dahl, G. C. Cotzias, D. D. Dziewiatkowski, and C. Harris, Dietary treatment of hypertension. II. Sodium depletion as related to the therapeutic effect, J.Clin.Invest. 30:584 (1951).
W. M. Kirkendall, W. E. Connor, F. D. Abboud, S. P. Rastogi, T. A. Anderson, and M. Fry, The effect of dietary sodium chloride on blood pressure, body fluids, electrolytes, renal function and serum lipids of normotensive man, J.Lab.Clin. Med. 87:418 (1976).
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Davies, D.L. et al. (1984). Sodium and Blood Pressure in Human Hypertension. In: Chazov, E.I., Smirnov, V.N., Oganov, R.G. (eds) Cardiology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1824-9_24
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DOI: https://doi.org/10.1007/978-1-4757-1824-9_24
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