Salt-Sensitive Hypertension: Perspectives on Intrarenal Mechanisms.
Salt-Sensitive Hypertension: Perspectives on Intrarenal Mechanisms.
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DOI：
10.2174/1573402111666150530203858
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发表时间：
2015
影响因子：
2.3
通讯作者：
Navar LG
中科院分区：
文献类型：
--
作者：
Majid DS;Prieto MC;Navar LG
盐敏感性高血压的特征是随着饮食中盐摄入量的增加而引起血压升高，并与心血管和肾脏发病率的风险增加有关。尽管研究人员几十年来一直试图了解人类对盐的敏感性是如何发展的，但高盐摄入导致血压升高的机制很复杂，而且只有部分了解。到目前为止，科学家们还无法解释为什么有些人对盐敏感，而另一些人对盐有抵抗力。虽然肾脏在盐敏感性和高血压的发展中的核心作用已被普遍接受，但人们也认识到高血压是多因素起源的，各种因素都可以诱导或阻止血压对盐摄入量的反应。易感人群摄入过量的盐也可能诱发不适当的中枢和交感神经系统反应，并增加肾内血管紧张素II、儿茶酚胺和其他因素（如氧化应激和炎性细胞因子）的产生。一个关键因素是伴随的不适当的或矛盾的激活肾内肾素-血管紧张素系统，高盐摄入。这通过盐敏感模型中高盐摄入期间尿血管紧张素原的增加来反映。神经内分泌因子和肾脏之间复杂的相互作用可能是某些个体保留盐和发展盐依赖性高血压的倾向的基础。在这篇综述中，我们主要集中在肾脏的贡献，提供慢性盐摄入和高血压的发展之间的机械联系。
Salt sensitive hypertension is characterized by increases in blood pressure in response to increases in dietary salt intake and is associated with an enhanced risk of cardiovascular and renal morbidity. Although researchers have sought for decades to understand how salt sensitivity develops in humans, the mechanisms responsible for the increases in blood pressure in response to high salt intake are complex and only partially understood. Until now, scientists have been unable to explain why some individuals are salt sensitive and others are salt resistant. Although a central role for the kidneys in the development of salt sensitivity and hypertension has been generally accepted, it is also recognized that hypertension is of multifactorial origin and a variety of factors can induce, or prevent, blood pressure responsiveness to the manipulation of salt intake. Excess salt intake in susceptible persons may also induce inappropriate central and sympathetic nervous system responses and increase the production of intrarenal angiotensin II, catecholamines and other factors such as oxidative stress and inflammatory cytokines. One key factor is the concomitant inappropriate or paradoxical activation of the intrarenal renin-angiotensin system, by high salt intake. This is reflected by the increases in urinary angiotensinogen during high salt intake in salt sensitive models. A complex interaction between neuroendocrine factors and the kidney may underlie the propensity for some individuals to retain salt and develop salt-dependent hypertension. In this review, we focus mainly on the renal contributions that provide the mechanistic link between chronic salt intake and the development of hypertension.