Key result
Salt sensitivity of blood pressure affects 27-51% of hypertensives and 18-47% of normotensives, but current clinical approaches lack sufficient sensitivity and specificity for routine identification.
Why the study?
No clinical approach has provided sufficient sensitivity and specificity to identify salt sensitivity of blood pressure, leaving it not routinely identified in the clinic despite its association with adverse cardiovascular outcomes.
Current clinical methods are insufficient to routinely identify salt sensitivity of blood pressure, highlighting the potential need for genetic biomarkers to guide personalized treatment.
BACKGROUND: Salt sensitivity of blood pressure (SSBP) is a trait observed in both humans and animals, characterized by an increase in blood pressure (BP) following salt loading or a drop in BP following salt depletion. SUMMARY: This "intermediate" phenotype has been reported in a sizable portion of individuals regardless of their hypertensive status; hypertensives (27-51%), normotensives (18-47%). Further, in epidemiological studies, this phenotype is associated with increased adverse cardiovascular outcomes, risk factors, and reduced survival rates. Herein, we review the challenges in the assessment of SSBP, heterogeneity in the assessment method and protocols, and how these differences could affect the results. Further, we review how to identify individuals with SSBP in the clinic by using clinical and genetic data. No clinical approach has yet provided sufficient sensitivity and specificity to identify those with SSBP. Thus, SSBP is not routinely identified in the clinic. Current genetic data suggest that genotyping may support such an office approach. To date, studies in 18 genes have provided sufficient evidence and reproducible data to identify potential mechanisms involved in subsets of subjects with hypertension and SSBP. KEY MESSAGE: Proof-of-concept clinical trials using genetic biomarkers to determine and treat individuals with SSBP are ongoing. Their results will provide critical evidence to support genetic-focused, mechanistically driven algorithms to identify and treat, specifically, individuals with SSBP - personalized medicine.
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Parksook et al. (2022) conducted a review in Salt sensitivity of blood pressure. Salt sensitivity of blood pressure was evaluated. Salt sensitivity of blood pressure affects 27-51% of hypertensives and 18-47% of normotensives, but current clinical approaches lack sufficient sensitivity and specificity for routine identification.
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