Sodium Imbalance and Hypertension: An Old and Current Disease

The global prevalence of hypertension in adults ranges between 30-40% of the population, with an age-standardized global prevalence between 24 and 20 in women and men, respectively. Individuals with hypertension face approximately 2,000 dollars higher annual healthcare expenditure compared to an individual who does not suffer from it. Although it is considered a disease of multifactorial origin, there is broad agreement that excess salt in the diet is the most important controllable factor in the increase in blood pressure. In the study of arterial hypertension and sensitivity to sodium, the sodium intake in humans in developed countries is subject to important variations from day to day. The balance in sodium is controlled almost entirely by the ability of the kidney to vary urinary sodium excretion. The immediate effect of ingested sodium in the diet is to modify plasma sodium and extracellular volume. The increase in plasma sodium is rapidly dampened by the increase in osmolarity that tends to move fluid from the intracellular space to the extracellular space. Small increases in plasma sodium also strongly stimulate the thirst center, causing increased water intake and vasopressin secretion. These mechanisms return sodium levels to baseline but increase extracellular volume, which stimulates other compensatory mechanisms involved in the regulation of vascular tone. More research with a better diagnostic definition and a higher number of participants should be conducted to improve outcomes in this group of patients.

Keywords: Cardiovascular disease, Diastolic blood pressure, Diet, Osmolality, Salt, Sodium, Systolic blood pressure.