Adverse effects of short-term, very-low-salt diets in subjects with risk-factor clustering.
Obesity is associated with risk-factor clustering, including risk factors for hypertension, hyperinsulinemia, resistance to insulin's lowering of glucose and fatty acid concentrations, and a complex dyslipidemia. Obese hypertensive subjects are presumed to be salt sensitive because of the antinatriuretic actions of insulin. However, in our studies obese hypertensive subjects aged < 45 y were not more salt sensitive than were lean individuals. Subjects with the greatest evidence for risk-factor clustering had higher renin and aldosterone concentrations, which increased with salt restriction. The greater rise of fatty acids and activation of the renin-angiotensin system may explain the larger elevations of blood pressure, insulin, and triacylglycerol with salt restriction in high-risk subjects than in low-risk subjects. Regardless of mechanism, the adverse effects of short-term, very-low-salt diets in high-risk subjects suggest that continued moderation in advice for universal salt restriction is appropriate.
Egan
B M
BM
Department of Pharmacology and Medicine, Medical University of South Carolina, Charleston 29425, USA.
Stepniakowski
K T
KT
D000375:Aging / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D004039:Diet, Sodium-Restricted / Q000009:adverse effects*; D004232:Diuretics / Q000627:therapeutic use; D005227:Fatty Acids / Q000097:blood; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications; D006973:Hypertension / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy; D009765:Obesity / Q000150:complications; D012084:Renin-Angiotensin System / Q000502:physiology; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology
D004232:Diuretics; D005227:Fatty Acids