Chrysant Steven G
From the University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Cardiol Rev. 2024;32(4):356-361. doi: 10.1097/CRD.0000000000000518. Epub 2023 Jun 5.
The incidence of salt-sensitive hypertension is quite common and varies between 30-60% in hypertensive patients. Regarding the causal role of high salt intake in the development of salt-sensitive hypertension, recent evidence has demonstrated that the gut through its microbiota plays a significant role in its genesis. Besides the gut, the kidneys also play important role in salt-sensitive hypertension and there is clinical and experimental evidence of an interrelationship between the gut and the kidneys in the development of salt-sensitive hypertension through the so-called "gastro-renal axis." The gut besides being an absorptive organ, it is also a hormonal secretory organ involving the secretion of gastrin, dopamine, norepinephrine, angiotensin, and aldosterone which through their action with the kidneys are involved in the development of salt-sensitive hypertension. In addition, the kidneys exert a protective role against the development of hypertension through the secretion of prostaglandins and their vasodilatory action. To assess the current evidence on the role of high salt intake and the interplay of the gut and kidneys in its development, a Medline search of the English literature was contacted between 2012 and 2022, and 46 pertinent papers were selected. These papers together with collateral literature will be discussed in this review.
盐敏感性高血压的发病率相当普遍，在高血压患者中为30%-60%。关于高盐摄入在盐敏感性高血压发生中的因果作用，最近的证据表明，肠道通过其微生物群在其发病机制中起重要作用。除了肠道，肾脏在盐敏感性高血压中也起重要作用，并且有临床和实验证据表明，通过所谓的“胃肠-肾轴”，肠道和肾脏在盐敏感性高血压的发生中存在相互关系。肠道除了是一个吸收器官外，还是一个激素分泌器官，涉及胃泌素、多巴胺、去甲肾上腺素、血管紧张素和醛固酮的分泌，这些激素通过与肾脏的相互作用参与盐敏感性高血压的发生。此外，肾脏通过分泌前列腺素及其血管舒张作用，对高血压的发生起到保护作用。为了评估关于高盐摄入的作用以及肠道和肾脏在其发生中的相互作用的现有证据，我们检索了2012年至2022年间的英文医学文献，共筛选出46篇相关论文。这些论文以及相关文献将在本综述中进行讨论。
