Department of Cardiology, Heraklion University Hospital, Heraklion, Greece.
Barts Heart Centre, St Bartholomew's Hospital, London, UK.
J Clin Hypertens (Greenwich). 2019 Jun;21(6):749-757. doi: 10.1111/jch.13535. Epub 2019 Apr 19.
Salt has been linked very closely to the occurrence and complications of arterial hypertension. A large percentage of patients with essential hypertension are salt-sensitive; that is, their blood pressure increases with increased salt intake and decreases with its reduction. For this reason, emphasis is placed on reducing salt intake to better regulate blood pressure. In day-to-day clinical practice this is viewed as mandatory for hypertensive patients who are judged to be salt-sensitive. Previous studies have highlighted the negative effect of high-salt diets on macrovascular function, which also affects blood pressure levels by increasing peripheral resistances. More recent studies provide a better overview of the pathophysiology of microvascular disorders and show that they are largely due to the overconsumption of salt. Microvascular lesions, which have a major impact on the functioning of vital organs, are often not well recognized in clinical practice and are not paid sufficient attention. In general, the damage caused by hypertension to the microvascular network is likely to be overlooked, while reversion of the damage is only rarely considered as a therapeutic target by the treating physician. The purpose of this review is to summarize the impact and the harmful consequences of increased salt consumption in the microvascular network, their significance and pathophysiology, and at the same time to place some emphasis on their treatment and reversion, mainly through diet.
盐与动脉高血压的发生和并发症密切相关。很大一部分原发性高血压患者对盐敏感;也就是说,他们的血压随着盐摄入量的增加而升高,随着盐摄入量的减少而降低。出于这个原因,重点是减少盐的摄入,以更好地调节血压。在日常临床实践中,对于被判断为盐敏感的高血压患者,这被视为强制性的。先前的研究强调了高盐饮食对大血管功能的负面影响,这也通过增加外周阻力来影响血压水平。最近的研究提供了对微血管疾病病理生理学的更好概述,并表明它们主要是由于盐摄入过多引起的。对重要器官功能有重大影响的微血管病变在临床实践中往往未被很好地认识,也没有得到足够的重视。一般来说,高血压对微血管网络造成的损害很可能被忽视,而治疗医生很少将逆转损害作为治疗目标。本综述的目的是总结盐摄入量增加对微血管网络的影响和有害后果,及其意义和病理生理学,同时主要通过饮食来强调其治疗和逆转。