Abstract
The pressure response to sodium is heterogeneous among both persons with normal blood pressure and with hypertension. Nevertheless, sodium restriction is typically recommended for everyone with hypertension. As reviewed here, categorizing a person as “salt sensitive” has important prognostic and therapeutic implications. Determination of salt sensitivity is typically accomplished by assessment of the pressure response to administration of an oral or intravenous sodium load. In this chapter, we discuss an alternative way to administer a sodium load through stress exposure. Animal and human studies have demonstrated clinically significant sodium retention during and after stress, which in effect generates positive sodium balance and thus delivers a sodium load. Persons demonstrating this response develop a volume-dependent blood pressure elevation. Similar to findings in salt-sensitive populations, target organ changes have also been associated with impaired sodium handling during stress. Sodium retention in response to stress has been reported as improved or reversed after treatment with antihypertensive medications that block the reninangiotensin- aldosterone system. Evidence suggests that the variability of the pressure response to dietary sodium intake and to stress should be considered in our strategies to prevent and control hypertension.
| Original language | English (US) |
|---|---|
| Title of host publication | Pediatric Hypertension |
| Publisher | Springer International Publishing |
| Pages | 221-232 |
| Number of pages | 12 |
| ISBN (Electronic) | 9783319311074 |
| ISBN (Print) | 9783319311067 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- Angiotensin II
- Obesity
- Pressure natriuresis
- Renin-angiotensinaldosterone system
- Salt sensitivity
- Sodium
- Stress-induced sodium retention
- Sympathetic nervous system
ASJC Scopus subject areas
- Medicine(all)
Cite this
Stress and salt sensitivity in childhood hypertension. / Hanevold, Coral D.; Harshfield, Gregory A.
Pediatric Hypertension. Springer International Publishing, 2018. p. 221-232.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Stress and salt sensitivity in childhood hypertension
AU - Hanevold, Coral D.
AU - Harshfield, Gregory A
PY - 2018/1/1
Y1 - 2018/1/1
N2 - The pressure response to sodium is heterogeneous among both persons with normal blood pressure and with hypertension. Nevertheless, sodium restriction is typically recommended for everyone with hypertension. As reviewed here, categorizing a person as “salt sensitive” has important prognostic and therapeutic implications. Determination of salt sensitivity is typically accomplished by assessment of the pressure response to administration of an oral or intravenous sodium load. In this chapter, we discuss an alternative way to administer a sodium load through stress exposure. Animal and human studies have demonstrated clinically significant sodium retention during and after stress, which in effect generates positive sodium balance and thus delivers a sodium load. Persons demonstrating this response develop a volume-dependent blood pressure elevation. Similar to findings in salt-sensitive populations, target organ changes have also been associated with impaired sodium handling during stress. Sodium retention in response to stress has been reported as improved or reversed after treatment with antihypertensive medications that block the reninangiotensin- aldosterone system. Evidence suggests that the variability of the pressure response to dietary sodium intake and to stress should be considered in our strategies to prevent and control hypertension.
AB - The pressure response to sodium is heterogeneous among both persons with normal blood pressure and with hypertension. Nevertheless, sodium restriction is typically recommended for everyone with hypertension. As reviewed here, categorizing a person as “salt sensitive” has important prognostic and therapeutic implications. Determination of salt sensitivity is typically accomplished by assessment of the pressure response to administration of an oral or intravenous sodium load. In this chapter, we discuss an alternative way to administer a sodium load through stress exposure. Animal and human studies have demonstrated clinically significant sodium retention during and after stress, which in effect generates positive sodium balance and thus delivers a sodium load. Persons demonstrating this response develop a volume-dependent blood pressure elevation. Similar to findings in salt-sensitive populations, target organ changes have also been associated with impaired sodium handling during stress. Sodium retention in response to stress has been reported as improved or reversed after treatment with antihypertensive medications that block the reninangiotensin- aldosterone system. Evidence suggests that the variability of the pressure response to dietary sodium intake and to stress should be considered in our strategies to prevent and control hypertension.
KW - Angiotensin II
KW - Obesity
KW - Pressure natriuresis
KW - Renin-angiotensinaldosterone system
KW - Salt sensitivity
KW - Sodium
KW - Stress-induced sodium retention
KW - Sympathetic nervous system
UR - http://www.scopus.com/inward/record.url?scp=85046488557&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046488557&partnerID=8YFLogxK
U2 - 10.1007/978-3-319-31107-4_18
DO - 10.1007/978-3-319-31107-4_18
M3 - Chapter
SN - 9783319311067
SP - 221
EP - 232
BT - Pediatric Hypertension
PB - Springer International Publishing
ER -