Department of Internal Medicine, Section of Nephrology, Amsterdam University Medical Centers, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands.
Hypertension Research Laboratory, School of Biological Sciences, and Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia; Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Kidney Int. 2023 Oct;104(4):690-697. doi: 10.1016/j.kint.2023.06.035. Epub 2023 Jul 14.
A high dietary sodium-consumption level is considered the most important lifestyle factor that can be modified to help prevent an increase in blood pressure and the development of hypertension. Despite numerous studies over the past decades, the pathophysiology explaining why some people show a salt-sensitive blood pressure response and others do not is incompletely understood. Here, a brief overview of the latest mechanistic insights is provided, focusing on the mononuclear phagocytic system and inflammation, the gut-kidney axis, and epigenetics. The article also discusses the effects of 3 types of novel drugs on salt-sensitive hypertension-sodium-glucose cotransporter 2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists, and aldosterone synthase inhibitors. The conclusion is that besides kidney-centered mechanisms, vasoconstrictor mechanisms are also relevant for both the understanding and treatment of this blood pressure phenotype.
高膳食钠摄入量被认为是最重要的生活方式因素,可以加以改变以帮助预防血压升高和高血压的发展。尽管过去几十年来进行了大量研究,但仍不完全了解为什么有些人表现出盐敏感性血压反应,而另一些人则没有。在这里,简要概述了最新的机制见解,重点关注单核吞噬细胞系统和炎症、肠道-肾脏轴和表观遗传学。本文还讨论了 3 种新型药物对盐敏感性高血压-钠-葡萄糖共转运蛋白 2 抑制剂、非甾体类盐皮质激素受体拮抗剂和醛固酮合酶抑制剂的影响。结论是,除了以肾脏为中心的机制外,血管收缩机制对于理解和治疗这种血压表型也很重要。