Salt: A Perpetrator of Hypertensive Target Organ Disease?

doi:10.1001/archinte.1997.00440420077006

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Vol. 157 No. 21, 24 NOVEMBER 1997

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Salt

A Perpetrator of Hypertensive Target Organ Disease?

Franz H. Messerli, MD; Roland E. Schmieder, MD; Matthew R. Weir, MD

Arch Intern Med. 1997;157(21):2449-2452.

Abstract

Experimental and clinical data suggest salt intake to be animportant factor in the pathogenesis of essential hypertension.However, the relationship between dietary sodium and blood pressurehas been found to be relatively weak, perhaps because casualblood pressure levels fluctuate considerably. We hypothesizedthat a closer correlation could be expected between salt intakeand the degree of hypertensive target organ disease. We reviewedthe literature for studies dealing with 24-hour urinary sodiumexcretion (as a measure of salt intake) and hypertensive targetorgan disease as assessed by left ventricular structure andfunction, microproteinuria, cerebrovascular disease, and arterialcompliance. Salt intake as assessed by 24-hour urinary sodiumexcretion was found to be a close independent determinant ofleft ventricular mass in 9 different studies worldwide. A reductionin dietary sodium has been shown to reduce left ventricularhypertrophy. There is clinical and experimental evidence, particularlyin salt-sensitive patients, that salt intake directly affectshypertensive renal disease, cerebrovascular disease, and complianceof the large arteries. The close and partially independent correlationbetween salt intake and hypertensive target organ disease suggestsdietary sodium to be a direct perpetrator of cardiovasculardisease.

Arch Intern Med. 1997;157:2449-2452

Author Affiliations

From the Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, La (Dr Messerli), the Department of Medicine, University of Erlangen-Nuremberg, Nuremberg, Germany (Dr Schmieder), and the Division of Nephrology, Department of Medicine, University of Maryland, Baltimore (Dr Weir).

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