Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
J Hum Hypertens. 2020 Feb;34(2):94-107. doi: 10.1038/s41371-018-0152-0. Epub 2019 Jan 10.
Hypertension is an enormous public-health challenge in the world due to its high prevalence and consequent increased cardiovascular disease morbidity and mortality. Observational epidemiologic studies and clinical trials have demonstrated a causal relationship between sodium intake and elevated blood pressure (BP). However, BP changes in response to sodium intervention vary among individuals-a trait called sodium sensitivity. This paper aims to review the recent advances in sodium-sensitivity research in Chinese and other populations. Older age, female gender, and black race are associated with high sodium sensitivity. Both genetic and environmental factors influence BP sodium sensitivity. Physical activity and dietary potassium intake are associated with reduced sodium sensitivity while obesity, metabolic syndrome, and elevated BP are associated with increased sodium sensitivity. Familial studies have documented a moderate heritability of sodium sensitivity. Candidate gene association studies, genome-wide association studies, whole-exome, and whole-genome sequencing studies have been conducted to elucidate the genomic mechanisms of sodium sensitivity. The Genetic Epidemiology Network of Salt Sensitivity (GenSalt) study, the largest family-based feeding study to date, was conducted among 1906 Han Chinese in rural northern China. This study showed that ~32.4% of Chinese adults were sodium sensitive. Additionally, several genetic variants were found to be associated with sodium sensitivity. Findings from the GenSalt Study and others indicate that sodium sensitivity is a reproducible trait and both lifestyle factors and genetic variants play a role in this complex trait. Discovering biomarkers and underlying mechanisms for sodium sensitivity will help to develop individualized intervention strategies for hypertension.
高血压是全球面临的巨大公共卫生挑战，其发病率高，导致心血管疾病发病率和死亡率增加。观察性流行病学研究和临床试验已经证明了钠摄入量与血压升高之间存在因果关系。然而，钠干预对血压的影响因人而异，这种特征被称为钠敏感性。本文旨在综述中国和其他人群中钠敏感性研究的最新进展。年龄较大、女性和黑种人易患高钠敏感性。遗传和环境因素都影响血压的钠敏感性。身体活动和膳食钾摄入与降低钠敏感性有关，而肥胖、代谢综合征和血压升高与增加钠敏感性有关。家族研究记录了钠敏感性具有中度遗传力。候选基因关联研究、全基因组关联研究、外显子组和全基因组测序研究已经开展，以阐明钠敏感性的基因组机制。盐敏感性遗传流行病学网络（GenSalt）研究是迄今为止最大的基于家族的喂养研究，在中国北方农村地区对 1906 名汉族人进行了研究。该研究表明，约 32.4%的中国成年人对钠敏感。此外，还发现了一些与钠敏感性相关的遗传变异。GenSalt 研究和其他研究的结果表明，钠敏感性是一种可重现的特征，生活方式因素和遗传变异都在这种复杂特征中起作用。发现钠敏感性的生物标志物和潜在机制将有助于为高血压制定个体化干预策略。
