SALT - A PERPETRATOR OF HYPERTENSIVE TARGET ORGAN DISEASE

Experimental and clinical data suggest salt intake to be an important factor in the pathogenesis of essential hypertension. However, the rel ationship between dietary sodium and blood pressure has been found to be relatively weak, perhaps because casual blood pressure levels fluct uate considerably. We hypothesized that a closer correlation could be expected between salt intake and the degree of hypertensive target org an disease. We reviewed the literature for studies dealing with 24-hou r urinary sodium excretion (as a measure of salt intake) and hypertens ive target organ disease as assessed by left ventricular structure and function, microproteinuria, cerebrovascular disease, and arterial com pliance. Salt intake as assessed by 24-hour urinary sodium excretion w as found to be a close independent determinant of left ventricular mas s in 9 different studies worldwide. A reduction in dietary sodium has been shown to reduce left ventricular hypertrophy. There is clinical a nd experimental evidence, particularly in salt-sensitive patients, tha t salt intake directly affects hypertensive renal disease, cerebrovasc ular disease, and compliance of the large arteries. The close and part ially independent correlation between salt intake and hypertensive tar get organ disease suggests dietary sodium to be a direct perpetrator o f cardiovascular disease.