Inverse salt sensitivity predicts CV damage in essential hypertension

Individuals with either salt sensitivity (SS) or inverse salt sensitivity (ISS) appear to be at greater risk of cardiovascular (CV) events, reveals a study.

Moreover, response to an acute saline test predicts CV damage among individuals with newly identified ISS, according to the authors.

A total of 844 naïve hypertensive patients participated in this study and underwent an acute saline test, during which blood pressure (BP) displayed either no substantial variation (salt-resistant, SR individuals), an increase (SS), or a paradoxical decrease (ISS).

Of the participants, 61 with the longest monitored follow-up (median 16 years) for BP and organ damage were included in the final analysis. The authors set up a clinical score for target organ damage (TOD) development based on the severity and the age of onset by considering hypertensive heart disease, cerebrovascular damage, microalbuminuria, and vascular events.

SS and ISS individuals encountered significantly higher CV events than their SR counterparts. The relative risk of developing CV events was 12.67 and 5.94 times higher in SS and in ISS patients, respectively, than SR individuals. In addition, the development of moderate-to-severe TOD was 10- and 15-fold higher in SS and ISS than in SR patients, respectively.

Among the three phenotypes, changes in plasma endogenous ouabain were associated with the BP effects of saline.

“SS is a powerful risk factor for CV disease and mortality in both normotensive and hypertensive patients,” the authors said.