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Sodium sensitivity of blood pressure in Chinese populations

Journal of Human Hypertension (2019) | Download Citation

Abstract

Hypertension is an enormous public-health challenge in the world due to its high prevalence and consequent increased cardiovascular disease morbidity and mortality. Observational epidemiologic studies and clinical trials have demonstrated a causal relationship between sodium intake and elevated blood pressure (BP). However, BP changes in response to sodium intervention vary among individuals—a trait called sodium sensitivity. This paper aims to review the recent advances in sodium-sensitivity research in Chinese and other populations. Older age, female gender, and black race are associated with high sodium sensitivity. Both genetic and environmental factors influence BP sodium sensitivity. Physical activity and dietary potassium intake are associated with reduced sodium sensitivity while obesity, metabolic syndrome, and elevated BP are associated with increased sodium sensitivity. Familial studies have documented a moderate heritability of sodium sensitivity. Candidate gene association studies, genome-wide association studies, whole-exome, and whole-genome sequencing studies have been conducted to elucidate the genomic mechanisms of sodium sensitivity. The Genetic Epidemiology Network of Salt Sensitivity (GenSalt) study, the largest family-based feeding study to date, was conducted among 1906 Han Chinese in rural northern China. This study showed that ~32.4% of Chinese adults were sodium sensitive. Additionally, several genetic variants were found to be associated with sodium sensitivity. Findings from the GenSalt Study and others indicate that sodium sensitivity is a reproducible trait and both lifestyle factors and genetic variants play a role in this complex trait. Discovering biomarkers and underlying mechanisms for sodium sensitivity will help to develop individualized intervention strategies for hypertension.

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Acknowledgements

Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number P20GM109036. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. YL is supported by a research training grant (D43TW009107) from the National Institutes of Health John E. Fogarty International Center, Bethesda, Maryland.

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Affiliations

  1. Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China

    • Yang Liu
  2. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    • Yang Liu
    • , Mengyao Shi
    • , Jacquelyn Dolan
    •  & Jiang He
  3. Louisiana State University School of Allied Health Professions, New Orleans, LA, USA

    • Jacquelyn Dolan

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The authors declare that they have no conflict of interest.

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Correspondence to Jiang He.

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https://doi.org/10.1038/s41371-018-0152-0