Luzardo Leonella, Noboa Oscar, Boggia José
Unidad de Hipertension Arterial, Centro de Nefrologia, Departamento de Fisiopatologia, Hospital de Clinicas Dr. Manuel Quintela, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay.
Curr Hypertens Rev. 2015;11(1):14-21. doi: 10.2174/1573402111666150530204136.
Hypertension and its consequences, including heart failure, stroke, and kidney disease, are responsible for substantial morbidity and mortality worldwide. Lifestyle changes, particularly sodium reduction, contribute to blood pressure control. However, not all individuals, whether normotensive or hypertensive, have the same susceptibility to the effects of salt. While a variety of approaches have been proposed to identify salt sensitive patients, there is no consensus for a definition of salt sensitivity and the precise mechanisms that explain their association are not yet fully understood. In this review we summarize the current understanding of the various pathophysiological mechanisms potentially involved in determining the salt sensitive phenotype. Genetic, neuronal, and immune alterations are reviewed. Additionally, we provide an update on the current knowledge of a new approach proposing the interstitium of the skin may act as a sodium reservoir. The role of dietary potassium on salt sensitive hypertension is also summarized.
高血压及其后果，包括心力衰竭、中风和肾脏疾病，在全球范围内导致了大量的发病和死亡。生活方式的改变，尤其是减少钠的摄入，有助于控制血压。然而，并非所有个体，无论血压正常与否，对盐的影响都具有相同的易感性。虽然已经提出了多种方法来识别盐敏感患者，但对于盐敏感性的定义尚未达成共识，并且解释其关联的精确机制也尚未完全了解。在本综述中，我们总结了目前对可能参与确定盐敏感表型的各种病理生理机制的理解。对遗传、神经和免疫改变进行了综述。此外，我们提供了一种新方法的最新知识，该方法提出皮肤间质可能充当钠储备库。还总结了膳食钾对盐敏感性高血压的作用。
