Effect of chronic sodium loading on cardiovascular response in young blacks and whites.

Falkner, Bonita; Kushner, Harvey

doi:10.1161/01.hyp.15.1.36

Cited by 103 publications

(52 citation statements)

References 47 publications

(24 reference statements)

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“…For example, newborn infants given a low-sodium diet had significantly lower BPs than did control newborns, and these effects persisted into adolescence (47). Randomization of adolescents to a high-or low-sodium diet (96) and evaluation of young adults after administration of an oral sodium load (33) showed that even younger individuals may be classified as sodium-sensitive or sodium-resistant based on observed changes in BP levels by 5 mm Hg. The GenSalt study observed a significant gradient in SBP from young to older adulthood; the greatest effect was seen in the oldest individuals (43).…”

Section: Sodium Intake and Cvd In Subpopulationsmentioning

confidence: 99%

“…Blacks excrete less sodium than do Whites after sodium loading (60,95), and investigators have observed that Blacks have greater elevation in BP in association with higher sodium intake compared with Whites or other ethnic groups (33,39,60,66,77,91,97). Blacks are also more often classified as salt-sensitive than are Whites (33,66).…”

Section: Ci: Confidence Intervalmentioning

confidence: 99%

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Sodium Intake and Cardiovascular Disease

Morrison

Ness

2011

Annu. Rev. Public Health

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Sodium consumption is a target for prevention of cardiovascular disease (CVD). The relationship between sodium intake and blood pressure (BP) is well-established, but the relationship with CVD is less clear. This review focuses on studies investigating the association between sodium intake and CVD within five principal subgroups: age, underlying BP, gender, body size, and ethnicity. We conclude that sodium reduction results in decreased CVD risk in the general population, and some susceptible subgroups may especially benefit from preventive efforts. Older individuals, those with underlying elevated BP, and those with increased body size may benefit most, but men and women of all ages, ethnicities, and normotensives also experience reduced CVD risk in relation to lowered sodium intake. Public health policy to reduce sodium intake in the United States would have significant cost-savings, far greater than the cost of intervention, and would also result in a significant gain in quality-adjusted life years.

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Section: Sodium Intake and Cvd In Subpopulationsmentioning

confidence: 99%

Section: Ci: Confidence Intervalmentioning

confidence: 99%

Sodium Intake and Cardiovascular Disease

Morrison

Ness

2011

Annu. Rev. Public Health

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“…Moreover, for both normotensives and hypertensives, the blood pressure of blacks is also more salt-sensitive compared with whites. [53][54][55][56][57] Nonetheless, it has proved difficult to demonstrate that blacks have a higher ECFV compared with whites. While an early study 58 in a small series of black hypertensives did report a significantly higher plasma volume in blacks compared with whites others have not been able to detect significant differences in either plasma and/or total blood volume between blacks and whites.…”

Section: Renal Sodium Retention and Extracellular Fluid Volume (Ecfv)mentioning

confidence: 99%

Why is plasma renin activity lower in populations of African origin?

Sagnella

2000

J Hum Hypertens

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Plasma renin activity is significantly lower in black people compared with whites independent of age and blood pressure status. The lower PRA appears to be due to a reduction in the rate of secretion of renin but the exact mechanistic events underlying such differences in renin release between blacks and whites are still not fully understood. Nevertheless, given the paramount importance of the renin-angiotensin system in the control of sodium balance, a most likely explanation is that the lower renin is a consequence of differences in renal sodium handling between blacks and whites. The lower PRA does not reflect differences in dietary sodium intake but the evidence available suggests that the low PRA could be part of the corrective mechanisms designed to maintain sodium balance in the presence of an increased tendency for sodium retention in black people. While it is possible that several factors may contribute to the reduced PRA, more recent investigation at

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“…22 However, these percentages were only 15% and 24% in white normotensive individuals and borderline hypertensives, respectively. Falkner and Kushner 23 reported a sodium-sensitive increase in blood pressure in young adults that was measured as 18% of whites and 37% of blacks. The retention of excess sodium and water causes volume overload and may contribute to the development of sustained high blood pressure in the black population.…”

Section: Racial Differences In Salt Sensitivitymentioning

confidence: 99%

Hypertension in Black Patients

Ergul

2000

Hypertension

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Abstract-The prevalence of essential hypertension in blacks is much higher than that in whites. In addition, the pathogenesis of hypertension appears to be different in black patients. For example, black patients present with a salt-sensitive hypertension characterized by low renin levels. Racial differences in renal physiology and socioeconomic factors have been suggested as possible causes of this difference, but reasons for this difference remain unclear.Endothelial cells are important in the regulation of vascular tonus and homeostasis, in part through the secretion of vasoactive substances. One of these factors, endothelin-1 (ET-1), is a 21 amino acid residue peptide with potent vasopressor actions. In addition to its contractile effects, it has been shown to stimulate mitogenesis in a number of cell types. Moreover, ET-1 displays modulatory effects on the endocrine system, including stimulation of angiotensin II and aldosterone production and inhibition of antidiuretic hormone in the kidney. Recent data from several laboratories indicate that ET-1 is overexpressed in the vasculature in several salt-sensitive models of experimental hypertension. Moreover, circulating plasma ET-1 levels are significantly increased in black hypertensives compared with white hypertensives. Thus, the ET system might be particularly important in the development or maintenance of hypertension in this population. (Hypertension. 2000;36:62-67.)Key Words: endothelin Ⅲ hypertension, essential Ⅲ blacks Ⅲ sodium, dietary Ⅲ race E pidemiological studies have established that black Americans have an increased prevalence of essential hypertension compared with white Americans. [1][2][3][4] Furthermore, the disease onset is earlier, and the consequences of hypertension, which include heart failure, myocardial infarction, stroke, and renal failure, are more pronounced in black patients. 1,5 These racial differences in the development and clinical course of hypertension have been attributed to environmental and physiological factors. 1,5 One hypothesis is that the development and progression of hypertension in blacks are related to abnormal hemodynamic reactivity characterized by increased peripheral vascular resistance in response to external stimuli, including physical and mental stress. 1,6 Although the mechanism for increased peripheral vascular resistance has not been elucidated, vasoactive substances produced by endothelial cells such as endothelin-1 (ET-1) and NO are possible candidates to contribute to the vascular reactivity in response to mental stress. [7][8][9] An increase in ET-1 levels, the most potent vasoconstrictor peptide with growthpromoting properties, 10 a decrease in NO production, or both would shift the balance in favor of vasoconstriction. Moreover, recent studies suggest that ET-1 and its receptors are also involved in the regulation of sodium and water reabsorption and excretion and may contribute to the development or maintenance of salt-sensitive hypertension. 11,12 Interestingly, black patients with essential hy...

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Effect of chronic sodium loading on cardiovascular response in young blacks and whites.

Cited by 103 publications

References 47 publications

Sodium Intake and Cardiovascular Disease

Sodium Intake and Cardiovascular Disease

Why is plasma renin activity lower in populations of African origin?

Hypertension in Black Patients

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