Cardiology pp 273-281 | Cite as

Sodium and Blood Pressure in Human Hypertension

  • D. L. Davies
  • C. Beretta-Piccoli
  • K. Boddy
  • J. J. Brown
  • R. Fraser
  • A. F. Lever
  • J. I. S. Robertson


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).


Arterial Pressure Essential Hypertension Dietary Sodium Exchangeable Sodium Raise Blood Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    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).Google Scholar
  2. 2.
    F. C. Husted, K. D. Nolph, and J. F. Maher, NaHCO3 and NaCl tolerance in chronic renal failure, J.Clin.Invest. 56:414 (1975).PubMedCrossRefGoogle Scholar
  3. 3.
    F. O. Simpson, Salt and hypertension: a sceptical review of the evidence, Clin.Sci. 57:463s (1979).Google Scholar
  4. 4.
    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).CrossRefGoogle Scholar
  5. 5.
    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).Google Scholar
  6. 6.
    G. W. Pickering, Salt intake and blood pressure, Cardiovasc.Revs.& Reports. 1:13 (1980).Google Scholar
  7. 7.
    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).Google Scholar
  8. 8.
    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).PubMedCrossRefGoogle Scholar
  9. 9.
    T. Morton, W. Adam, A. Gillies, M. Wilson, G. Morgan, and S. Carney, Hypertension treated by salt restriction, Lancet 1:227 (1978).Google Scholar
  10. 10.
    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).Google Scholar
  11. 11.
    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).Google Scholar
  12. 12.
    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).CrossRefGoogle Scholar
  13. 13.
    R. Reader, The Australian therapeutic trial in mild hypertension, Report by the Management Committee, Lancet 1:1261 (1980).Google Scholar
  14. 14.
    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).Google Scholar
  15. 15.
    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).Google Scholar
  16. 16.
    D. L. Davies, and J. W. K. Robertson, Simultaneous measurement of total exchangeable potassium and sodium using 24K and 24Na, Metabolism 22:133 (1973).PubMedCrossRefGoogle Scholar
  17. 17.
    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).Google Scholar
  18. 18.
    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).CrossRefGoogle Scholar
  19. 19.
    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).CrossRefGoogle Scholar
  20. 20.
    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).PubMedCrossRefGoogle Scholar
  21. 21.
    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).PubMedCrossRefGoogle Scholar
  22. 22.
    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).Google Scholar

Copyright information

© Springer Science+Business Media New York 1984

Authors and Affiliations

  • D. L. Davies
    • 2
  • C. Beretta-Piccoli
    • 1
  • K. Boddy
    • 3
  • J. J. Brown
    • 1
  • R. Fraser
    • 1
  • A. F. Lever
    • 1
  • J. I. S. Robertson
    • 1
  1. 1.MRC Blood Pressure UnitScotland
  2. 2.Gardiner Institute Department of MedicineWestern InfirmaryGlasgowScotland
  3. 3.The Scottish Universities Research and Reactor CentreEast KilbridgeScotland

Personalised recommendations