Chloride as a Determinant of Salt-Sensitivity

  • T. W. Kurtz
  • R. C. MorrisJr.
Conference paper


In some patients with essential hypertension, blood pressure decreases with restriction of dietary salt (NaCI, sodium chloride) and increases with its subsequent supplementation — responses now said to characterize “salt-sensitive” hypertension (Fujita et al. 1980). Although Ambard and Beaujard suggested in 1904 that increased retention of chloride might be involved in the pathogenesis of hypertension (Ambard and Beaujard 1904), a half century later Dahl asserted that “the sodium ion alone is important” in the hypertensinogenic capacity of dietary NaCI (Dahl and Love 1954). The now prevalent view is that the capacity of sodium chloride to increase blood pressure depends only on its sodium component and that, hence, all commonly ingested sodium salts have this capacity (Dahl 1960; Wallis 1982; Jacobson et al. 1983). However, the results from studies performed over 50 years ago, as well as from more recent studies, provide support for an alternative hypothesis: For NaCI to increase blood pressure, both its sodium and chloride components are necessary; hence, restriction of either sodium or chloride may be sufficient to attenuate a NaCl-induced increase in blood pressure.


Essential Hypertension Sodium Salt Increase Blood Pressure Important Biological Effect Increase Plasma Volume 
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  1. Addison WLT (1928) The use of sodium chloride, potassium chloride, sodium bromide, and potassium bromide in cases of arterial hypertension which are amenable to potassium chloride. Can Med Assoc J 18:281–285PubMedGoogle Scholar
  2. Ambard L, Beaujard E (1904) Causes de l’hypertension arterielle. Arch Gen De Med 1:520–533Google Scholar
  3. Berghoff RS, Geraci AS (1929) The influence of sodium chloride on blood pressure. IJ 56:395–397Google Scholar
  4. Dahl LK (1960) Possible role of salt intake in the development of essential hypertension. In: Essential hypertension, an international symposium. Springer Berlin, Heidelberg, New York, pp 58–65Google Scholar
  5. Dahl LK, Love RA (1954) Evidence for relationship between sodium (chloride) intake and human essential hypertension. Arch Intern Med 94:525–531Google Scholar
  6. Dole VP, Dahl LK, Cotzias GC, Eder HA, Krebs ME (1950) Dietary treatment of hypertension. Clinical and metabolic studies of patients on the rice-fruit diet. J Clin Invest 29:1189–1206PubMedCrossRefGoogle Scholar
  7. Fregly MS, Fregly MJ (1982) The estimates of sodium intake by man. In: Fregly MJ, Kare MR (eds) The role of salt in cardiovascular hypertension. Academic, New York, pp 3–17Google Scholar
  8. Fujita T, Henry W, Barrter F, Lake C, Delea C (1980) Factors influencing blood pressure in salt-sensitive patients with hypertension. Am J Med 69:334–344PubMedCrossRefGoogle Scholar
  9. Grollman A, Harrison TR (1945) Effect of rigid sodium restriction on blood pressure and survival of hypertensive rats. Proc Soc Exp Biol Med 60:52–55PubMedGoogle Scholar
  10. Grollman A, Harrison TR, Mason MF, Baxter J, Crampton J, Reichsman F (1945) Sodium restriction in the diet for hypertension. JAMA 129:533–537Google Scholar
  11. Hamlyn JM, Blaustein MP (1986) Sodium chloride, extracellular fluid volume, and blood pressure regulation. Am J Physiol 251:F563-F575PubMedGoogle Scholar
  12. Jacobson M, Liebman BF, Moyer G (1983) Salt: the brand name guide to sodium content. Workman, New YorkGoogle Scholar
  13. Kurtz TW, Morris RC Jr (1983) Dietary chloride as a determinant of “sodium-dependent” hypertension. Science 222:1139–1140PubMedCrossRefGoogle Scholar
  14. Kurtz TW, Morris RC Jr (1985) Dietary chloride as a determinant of disordered calcium metabolism in salt-dependent hypertension. Life Sci 36:921–929PubMedCrossRefGoogle Scholar
  15. Kurtz TW, Al-Bander HA, Morris RC (1987) Salt-sensitive essential hypertension in men: is the sodium ion alone important? N Engl Med 317:1043–1048CrossRefGoogle Scholar
  16. Liebman BF, Langford HG (1985) Hypertension and sodium salts. Science 228:351–352PubMedCrossRefGoogle Scholar
  17. Lowder SC, Brown RD (1975) Hypertension corrected by discontinuing chronic sodium bicarbonate ingestion. Am J Med 58:272–279PubMedCrossRefGoogle Scholar
  18. Morgan T (1982) The effect of potassium and bicarbonate ions on the rise in blood pressure caused by sodium chloride. Clin Sci 63:407s-409sGoogle Scholar
  19. Motoyama T, Sano H, Suzuki H, Kawaguchi K, Fukuzaki H, Yamanishi J, Furuta Y, Omatsu T, Saito K (1987) The role of chloride on deoxycorticosterone acetate-salt hypertension. Jpn Cire J 51:1191–1198CrossRefGoogle Scholar
  20. Passmore JC, Whitescarver SA, Ott CE, Kotchen TA (1985) Importance of chloride for deoxycorticosterone-salt hypertension in the rat. Hypertension 7:I115-I120PubMedGoogle Scholar
  21. Resnick LM, Nicholson J, Laragh J (1985) Alterations in calcium metabolism mediate dietary salt sensitivity in essential hypertension. Trans Assoc Am Physicians 98:313–321PubMedGoogle Scholar
  22. Shore AC, Markandu ND, MacGregor G A (1987) Sodium loading in patients with essential hypertension. Proceedings of the American society of hypertension 2:78Google Scholar
  23. Wallis C (1982) Salt: a new villain? Time Magazine, March 15:64–71Google Scholar
  24. Whitescarver SA, Ott CE, Jackson B, Guthrie GP, Kotchen TA (1984) Salt-sensitive hypertension: contribution of chloride. Science 223:1430–1432PubMedCrossRefGoogle Scholar
  25. Whitescarver SA, Ott CE, Jackson B, Guthrie GP, Kotchen TA (1986) Effect of dietary chloride on salt-sensitive and renin dependent hypertension. Hypertension 8:56–61PubMedGoogle Scholar
  26. Wyss JM, Liumsiricharven M, Sripairojthikoon W, Brown D, Gist R, Oparil S (1987) Exacerbation of hypertension by high chloride, moderate sodium diet in the salt-sensitive spontaneously hypertensive rat. Hypertension 9:[Suppl III] 171–175Google Scholar
  27. Zadunaisky JA (ed) (1982) Chloride transport in biological membranes. Academic, New YorkGoogle Scholar
  28. Zidek W, Losse H, Lange-Asschenfeldt H, Vetter H (1985) Intracellular chloride in essential hypertension. Clin Sci 68:45–7PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • T. W. Kurtz
  • R. C. MorrisJr.

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