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Journal of Hypertension:
doi: 10.1097/HJH.0b013e3281139ebd
Original papers: Kidney

Incidence of hypertension in individuals with different blood pressure salt-sensitivity: results of a 15-year follow-up study

Barba, Gianvincenzoa; Galletti, Ferrucciob; Cappuccio, Francesco Pc; Siani, Alfonsoa; Venezia, Antonellab; Versiero, Marcob; Della Valle, Elisabettad; Sorrentino, Paolob; Tarantino, Giovannib; Farinaro, Eduardod; Strazzullo, Pasqualeb

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Abstract

Objective: To evaluate the incidence of hypertension and the rate of decline in renal function in a sample of 47 Olivetti Heart Study (OHS) participants whose blood pressure (BP) salt-sensitivity and renal tubular sodium handling had been assessed in 1987–88.

Methods: During the 2002–04 OHS follow-up examination, medical history, physical examination and blood and urine sampling were performed in 36 of the 47 participants to the baseline study (age 60 ± 6 years; average follow-up = 15.1 ± 0.6 years). The renal length was measured in 23 participants by kidney ultrasonography. Based on the baseline salt-sensitivity evaluation, the subjects were classified into a lower salt-sensitivity (LSS, n = 20) and a higher salt-sensitivity group (HSS, n = 16).

Results: In comparison with the LSS group, HSS participants had a significantly higher incidence of hypertension (87.5 versus 50.0%, P = 0.02), a higher glomerular filtration rate (median, first to fourth quartile: 81.9, 72.3–95.2 versus 72.3, 59.9–81.2 ml/min; P = 0.03) and greater kidney length (median, first to fourth quartile: 68.2, 63.3–72.1 versus 61.9, 58.7–62.7 mm/m of height; P = 0.003). The incidence of hypertension remained significantly higher in HSS individuals after adjustment for age, intercurrent changes in body mass index and baseline blood pressure on low sodium diet (P = 0.04).

Conclusion: Our findings indicate that individuals with higher BP salt-sensitivity have a higher rate of incident hypertension and suggest an altered renal tubular sodium handling involving a trend to increased glomerular filtration rate and blood pressure over time as a possible mechanism.

© 2007 Lippincott Williams & Wilkins, Inc.

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