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Skin regulation of salt and blood pressure and potential clinical implications

Hypertension Research volume 46, pages 408–416 (2023)Cite this article

Abstract

Sodium chloride, as salt, gives rise to hypertension. Nevertheless, individual susceptibility to the ramifications of sodium chloride is heterogeneous. The conventional nephron-centric regulation of sodium with neurohormonal inputs and responses is now expanded to include an intricate extrarenal pathway including the endothelium, skin, lymphatics, and immune cells. An overabundance of sodium is buffered and regulated by the skin interstitium. Excess sodium passes through (and damages) the vascular endothelium and can be dynamically stored in the skin, modulated by skin immune cells and lymphatics. This excess interstitially stored sodium is implicated in hypertension, cardiovascular dysfunction, metabolic disruption, and inflammatory dysregulation. This extrarenal pathway of regulating sodium represents a novel target for better blood pressure management, rebalancing disturbed inflammation, and hence addressing cardiovascular and metabolic disease.

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Acknowledgements

KM is supported by the University of Melbourne Professional and Practice-Based Research Training Program Scholarship and The Royal Melbourne Hospital Margaret Henderson Women in Research Fellowship.

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  1. Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia

    Kylie Martin, Nigel D. Toussaint, Sven-Jean Tan & Timothy D. Hewitson

  2. Department of Medicine, University of Melbourne, Parkville, Victoria, Australia

    Kylie Martin, Nigel D. Toussaint, Sven-Jean Tan & Timothy D. Hewitson

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Martin, K., Toussaint, N.D., Tan, SJ. et al. Skin regulation of salt and blood pressure and potential clinical implications. Hypertens Res 46, 408–416 (2023). https://doi.org/10.1038/s41440-022-01096-8

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