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Canadian Journal of Cardiology

Taking Another “Look” at Sodium

  • Jens Titze
    Affiliations
    Junior Research Group 2, Interdisciplinary Centre for Clinical Research, Nikolaus-Fiebiger-Centre for Molecular Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany

    Department of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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  • Dominik N. Müller
    Affiliations
    Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité Medical Faculty, Berlin, Germany
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  • Friedrich C. Luft
    Correspondence
    Corresponding author: Dr Friedrich C. Luft, ECRC, Lindenbergerweg 80, 13125 Berlin, Germany.
    Affiliations
    Department of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

    Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité Medical Faculty, Berlin, Germany
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Published:February 18, 2014DOI:https://doi.org/10.1016/j.cjca.2014.02.006
      A high-salt dietary intake has been implicated in cardiovascular disease, glucose intolerance, autoimmune conditions, and even cancer. A high-salt diet interferes with treatment responses to antihypertensive drugs, the most common medications prescribed, and is presumed to exacerbate heart failure. Preliminary evidence exists that a high-salt diet is a treatment barrier for disease. However, the overarching mechanisms explaining how the increased risk comes about by ingesting a high-salt diet are unclear. Although a link between a high-salt intake and increased blood pressure appears irrefutable, the precise mechanisms remain elusive. According to textbook teaching, body salt content is maintained constant after a few days when salt intake is altered (steady state), because 24-hour Na+ excretion is similar to intake. Na+ resides extracellularly. The Na+ concentration is similar in plasma and interstitium, thereby creating an isotonic microenvironment, which bathes the body's cells. Thus, Na+ in the body and volume regulation are closely coupled. Na+ retention results in volume expansion with circulatory adjustments to maintain tissue flows constant, and Na+ depletion is associated with volume depletion.
      • Coleman T.G.
      • Granger H.J.
      • Guyton A.C.
      Whole-body circulatory autoregulation and hypertension.
      Blood pressure changes should happen accordingly. But are matters indeed that straightforward?
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