Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.
Department of Medicine (DIMED), University of Padua, Padua, Italy.
Curr Hypertens Rep. 2022 May;24(5):115-122. doi: 10.1007/s11906-022-01180-x. Epub 2022 Feb 22.
The regulation of blood pressure is conventionally conceptualised into the product of "circulating blood volume" and "vasoconstriction components". Over the last few years, however, demonstration of tissue sodium storage challenged this dichotomous view.
We review the available evidence pertaining to this phenomenon and the early association made with blood pressure; we discuss open questions regarding its originally proposed hypertonic nature, recently challenged by the suggestion of a systemic, isotonic, water paralleled accumulation that mirrors absolute or relative extracellular volume expansion; we present the established and speculate on the putative implications of this extravascular sodium excess, in either volume-associated or -independent form, on blood pressure regulation; finally, we highlight the prevalence of high tissue sodium in cardiovascular, metabolic and inflammatory conditions other than hypertension. We conclude on approaches to reduce sodium excess and on the potential of emerging imaging technologies in hypertension and other conditions.
传统观念认为血压的调节源于“循环血量”和“血管收缩成分”的乘积。然而，在过去的几年中，组织钠储存的证明对这种二分法提出了挑战。
我们回顾了与这一现象相关的现有证据以及它与血压的早期关联；我们讨论了最初提出的高渗性质的开放性问题，最近的观点认为其是一种系统性、等渗的、与水平行的积累，反映了绝对或相对细胞外容量的扩张；我们介绍了已经确定的，并推测了这种细胞外过多的钠在血压调节中的作用，无论是以容量相关还是非容量相关的形式；最后，我们强调了在高血压和其他疾病以外的心血管、代谢和炎症条件下，组织内钠含量过高的普遍存在。我们总结了减少钠过多的方法，并强调了新兴成像技术在高血压和其他疾病中的应用潜力。
