The time course of salt-induced hypertension, and why it matters
Abstract
The epidemiology of salt-induced hypertension has been explored in detail in animal studies, in some cases involving exposures to excess dietary salt for much of the animal's lifespan. The results of these studies demonstrate the presence of two distinct time courses of the blood pressure response to a high salt intake: an acute (rapid) blood pressure response occurring over days to weeks, and a slow and progressive blood pressure response that develops over extremely long periods of time, amounting to a significant fraction of the lifespan in normal individuals. The acute form of salt sensitivity is well known in humans, having often been demonstrated as a fall in blood pressure during the period of salt restriction. The slow and progressive form of salt sensitivity has been demonstrated directly in rats and chimpanzees and is also evident in analyses of human cross-population data as a salt dependency of age-associated changes of blood pressure. This slow and progressive component of salt-induced hypertension may be attributable, at least in part, to a progressive rise in the acute salt sensitivity of blood pressure during sustained exposure to high salt. However, a progressively irreversible or 'self sustaining' component of salt-induced hypertension has also been demonstrated in rat studies. This irreversible component has not been completely characterized, but its presence raises the possibility that blood pressure responses to salt restriction may not fully reveal the contribution of salt to blood pressure or the epidemiology of hypertension. These various components of salt sensitivity (acute vs slow, reversible vs irreversible) should be considered in any comprehensive explanation of the effects of salt on blood pressure and especially in experimental studies of the genetic and physiological mechanisms underlying salt-induced hypertension.
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Chronically high dietary sodium may induce other, blood-pressure-independent effects, such as increasing myocardial, arterial, and renal fibrosis and dysfunction.
“and also induce other, BP-independent effects, for example increasing myocardial, arterial, and renal fibrosis and dysfunction.29,30”
From Global Sodium Consumption and Death from Cardiovascular Causes (2014) · cites this paper as [30]
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Burnier, M. (2007) · CRC Press eBooks · doi:10.3109/9781420020946-13 · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 108 references couldn’t be matched to a known paper.
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Global Sodium Consumption and Death from Cardiovascular Causes
Mozaffarian, D., Fahimi, S., Singh, G. M., Micha, R., Khatibzadeh, S., Engell, R. E., Lim, S., Danaei, G., Ezzati, M., & Powles, J. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1304127 · Cited by 1,218 · see citing works
Sodium Reduction and Its Effect on Food Safety, Food Quality, and Human Health
Doyle, M. E., & Glass, K. A. (2009) · Comprehensive Reviews in Food Science and Food Safety · doi:10.1111/j.1541-4337.2009.00096.x · Cited by 415 · see citing works
Dietary Sodium and Cardiovascular Disease Risk — Measurement Matters
Cogswell, M. E., Mugavero, K., Bowman, B. A., & Frieden, T. R. (2016) · New England Journal of Medicine · doi:10.1056/nejmsb1607161 · Cited by 211 · see citing works
Scheelbeek, P., Chowdhury, M. A. H., Haines, A., Alam, D. S., Hoque, M. A., Butler, A. P., Khan, A. E., Mojumder, S. K., Blangiardo, M., Elliott, P., et al. (2017) · Environmental Health Perspectives · doi:10.1289/ehp659 · Cited by 117 · see citing works
Parati, G., Lackland, D. T., Campbell, N. R. C., Owolabi, M. O., Bavuma, C. M., Beheiry, H., Dzudié, A., Ibrahim, M. M., Aroussy, W. A. E., Singh, S. K., et al. (2022) · Hypertension · doi:10.1161/hypertensionaha.121.18884 · Cited by 90 · see citing works
“44,45 In addition, patients of black ancestry may have greater increases in BP when excess salt is consumed.”
BackgroundCampbell, N. R. C., Whelton, P. K., Orías, M., Wainford, R. D., Cappuccio, F. P., Ide, N., Neal, B. C., Cohn, J., Cobb, L. K., Webster, J. L., et al. (2022) · Journal of Human Hypertension · doi:10.1038/s41371-022-00690-0 · Cited by 81 · see citing works
“The INTERSALT study and animal studies indicate high dietary sodium consumption may have a substantively larger life course impact on BP than is identified in the currently available relatively short-term sodium reduction trials and suggest that a component of the increased BP may be irreversible [9, 10].”
BackgroundWong, S. K., Chin, K., Suhaimi, F. H., Ahmad, F., & Ima-Nirwana, S. (2017) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0043-119352 · Cited by 63 · see citing works
Faulkner, J., Harwood, D., Bender, L., Shrestha, L., Brands, M. W., Morwitzer, M. J., Kennard, S., Antonova, G. N., & de Chantemèle, E. J. B. (2018) · Hypertension · doi:10.1161/hypertensionaha.118.11303 · Cited by 58 · see citing works
Proposed Nomenclature for Salt Intake and for Reductions in Dietary Salt
Campbell, N. R. C., Correa‐Rotter, R., Cappuccio, F. P., Webster, J. L., Lackland, D. T., Neal, B. C., & MacGregor, G. A. (2014) · Journal of Clinical Hypertension · doi:10.1111/jch.12442 · Cited by 50 · see citing works
“salt).(33,36,38,39) Hence, in part for ease of classification, we recommend defining normal (physiological) ranges of salt intake as <2.”
BackgroundSodium Consumption: An Individual′s Choice?
Campbell, N. R. C., Johnson, J. A., & Campbell, T. S. (2012) · International Journal of Hypertension · doi:10.1155/2012/860954 · Cited by 47 · see citing works
“…increases in blood pressure, age-related increases in blood pressure, the epigenetic phenomena, whereby exposure to excess salt in utero may increase blood pressure in o ff spring, or that sodium may increase vascular and cardiac disease in the absence of changes in blood pressure [7, 8, 12, 19–21].”
Thick Ascending Limb Sodium Transport in the Pathogenesis of Hypertension
Gonzalez‐Vicente, A., Sáez, F., Monzon, C. M., Asirwatham, J., & Garvin, J. L. (2018) · Physiological Reviews · doi:10.1152/physrev.00055.2017 · Cited by 46 · see citing works
Khan, S., Khan, T., & Shah, A. J. (2018) · Phytomedicine · doi:10.1016/j.phymed.2018.04.046 · Cited by 40 · see citing works
Campbell, N. R. C., Appel, L. J., Cappuccio, F. P., Correa‐Rotter, R., Hankey, G. J., Lackland, D. T., MacGregor, G. A., Neal, B. C., Niebylski, M. L., Webster, J. L., et al. (2014) · Journal of Clinical Hypertension · doi:10.1111/jch.12364 · Cited by 36 · see citing works
The Science of Salt: A Systematic Review of Clinical Salt Studies 2013 to 2014
Johnson, C., Thout, S. R., Trudeau, L., Bacon, S., Padwal, R. S., Webster, J. L., & Campbell, N. R. C. (2015) · Journal of Clinical Hypertension · doi:10.1111/jch.12529 · Cited by 34 · see citing works
Saha, S., Nordström, J., Gerdtham, U., Mattisson, I., Nilsson, P. M., & Scarborough, P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16050890 · Cited by 26 · see citing works
“effects of salt reduction on cardiovascular disease) [35] or even decades (e.”
BackgroundUnderstanding the science that supports population‐wide salt reduction programs
Webster, J. L., Waqanivalu, T., Arcand, J., Trieu, K., Cappuccio, F. P., Appel, L. J., Woodward, M., Campbell, N. R. C., & McLean, R. M. (2017) · Journal of Clinical Hypertension · doi:10.1111/jch.12994 · Cited by 21 · see citing works
A maternal high salt diet disturbs cardiac and vascular function of offspring
Maruyama, K., Kagota, S., Vliet, B. N. V., Wakuda, H., & Shinozuka, K. (2015) · Life Sciences · doi:10.1016/j.lfs.2015.06.023 · Cited by 20 · see citing works
Zheng, X., Sen, J. B., Li, Z., Sabouri, M., Samarah, L., Deacon, C. S., Bernardo, J., & Machin, D. R. (2023) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00415.2022 · Cited by 19 · see citing works
Salt sensitivity of blood pressure in childhood and adolescence
Hanevold, C. D. (2021) · Pediatric Nephrology · doi:10.1007/s00467-021-05178-6 · Cited by 18 · see citing works
Efforts to Reduce Sodium Intake in Canada: Why, What, and When?
Vliet, B. N. V., & Campbell, N. R. C. (2011) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2011.04.012 · Cited by 17 · see citing works
Dietary Sodium: A Perspective on Recent Sodium Evidence—Its Interpretation and Controversies
Campbell, N. R. C., Lackland, D. T., & MacGregor, G. A. (2013) · Journal of Clinical Hypertension · doi:10.1111/jch.12187 · Cited by 15 · see citing works
“A wide variety of animal species exposed to higher than physiological levels of dietary sodium develop hypertension, vascular, cardiac, and renal adverse outcomes.(4,13) To our knowledge, barring settings of acute sodium depletion, there is no animal species in which higher than physiological sodium intake improves he…”
BackgroundAhmad, T., Javed, A., Khan, T., Althobaiti, Y. S., Ullah, A., Almutairi, F. M., & Shah, A. J. (2022) · Pharmaceuticals · doi:10.3390/ph15080951 · Cited by 16 · see citing works
“The changes in the MAP were calculated using the following formula with the SBP and DBP values [52,53]:”
MethodSaha, S., Nordström, J., Mattisson, I., Nilsson, P. M., & Gerdtham, U. (2019) · Nutrients · doi:10.3390/nu11061434 · Cited by 16 · see citing works
“The Nordic countries could consider lowering the recommended level, since the American Heart Association has suggested reducing salt intake to 3.75 g / day for the primary prevention of CVDs [47].”
BackgroundInfluentialA multi-component model of the dynamics of salt-induced hypertension in Dahl-S rats
McLoone, V. I., Ringwood, J. V., & Vliet, B. N. V. (2009) · BMC Physiology · doi:10.1186/1472-6793-9-20 · Cited by 9 · see citing works
“Finally, an effect of sustained salt loading to alter the slope of the chronic pressure natriuresis relationship, amounting to a salt induced worsening of acute saltsensitivity, has also been suggested [13,14].”
BackgroundHemodynamic responses to mental stress during salt loading
Gefke, M., Christensen, N. J., Bech, P., Frandsen, E., Damgaard, M., Asmar, A., & Norsk, P. (2016) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12360 · Cited by 8 · see citing works
Association between animal source foods consumption and risk of hypertension: a cohort study
Liang, J., Zhao, J., Wang, J., & Wang, T. (2020) · European Journal of Nutrition · doi:10.1007/s00394-020-02423-w · Cited by 6 · see citing works
Vanderriele, P., Wang, Q., Mérillat, A., Ino, F., Aeschlimann, G., Ehret, X., Olmo, D. A. D., de León, V. P., Scholl, U. I., Winter, D. V., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms222413218 · Cited by 6 · see citing works
Highlights in clinical autonomic neuroscience: how much salt is salubrious?
Cheshire, W. P. (2013) · Autonomic Neuroscience · doi:10.1016/j.autneu.2013.07.003 · Cited by 5 · see citing works
“…studies have defined salt sensitivity in terms of the blood pressure response to short-term sodium ingestion or intravenous loading, if the long-term effects of excessive salt intake (Van Vliet and Montani, 2008) were taken into account, it is possible that the prevalence might be even higher.”
Christoffersen, B. Ø., Kristensen, C. A., Lindgaard, R., Kirk, R. K., Viuff, B. M., Kvist, P. H., Pedersen, H. D., Ludvigsen, T. P., Skovgaard, T., Fels, J. J., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-32674-6 · Cited by 4 · see citing works
Modelling of Long and Short Term BloodPressure Control Systems
McLoone, V. I. (2014) · Maynooth University ePrints and eTheses Archive (Maynooth University) · Cited by 3 · see citing works
¿Es la hipertensión sensible a sal una enfermedad inflamatoria? Papel de los linfocitos y macrófagos
González-Toledo, R., & Franco, M. (2012) · Archivos de cardiología de México · doi:10.1016/j.acmx.2012.06.006 · Cited by 2 · see citing works
Stress and Salt Sensitivity in Childhood Hypertension
Hanevold, C. D., & Harshfield, G. A. (2013) · Humana Press eBooks · doi:10.1007/978-1-62703-490-6_18 · Cited by 2 · see citing works
RALAHIRAVO, D. Y., RAKOTOARISON, O., Randimbivololona, F., Quansah, N., & RANDRIANAVONY, P. (2023) · World Journal of Biology Pharmacy and Health Sciences · doi:10.30574/wjbphs.2023.13.2.0110 · Cited by 1 · see citing works
“Every morning, at the same time, animal’s blood pressure was measured with a tail cuff sphygmomanometer, in a quiet place, and high sodium diet was stopped when the blood pressure was maximal [18].”
MethodMagwebu, Z. E., Khoza, S., Mazinu, M., Jordaan, E., Ghai, M., & Chauke, C. G. (2025) · BMC Veterinary Research · doi:10.1186/s12917-025-04795-9 · Cited by 1 · see citing works
Stress and Salt Sensitivity in Childhood Hypertension
Hanevold, C. D., & Harshfield, G. A. (2018) · Springer eBooks · doi:10.1007/978-3-319-31107-4_18 · Cited by 1 · see citing works
A 5-component mathematical model for salt-induced hypertension in Dahl-S and Dahl-R rats
McLoone, V. I., Ringwood, J. V., & Vliet, B. V. (2010) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2010.04.008
Chleilat, F. (2016) · The Atrium (University of Guelph)
Inserra, F., Salazar, M., Wassermann, A., Lavenia, G., Miatello, R. M., Renna, N. F., Janson, J. J., & Filippini, F. (2014) · Revista Argentina de Cardioangiología Intervencionista · doi:10.30567/raci/201404/0253-0263
Arce, T. A. M. C., & Cuba, F. S. (2021) · International Journal of Health Science · doi:10.22533/at.ed.1592108108
Stress and Salt Sensitivity in Childhood Hypertension
Hanevold, C. D., & Harshfield, G. A. (2017) · Springer eBooks · doi:10.1007/978-3-319-31420-4_18-1
ALI, M. I., Ismail, M. A. G. M., Zalat, R., Ghieth, M. A., Gawad, S. S. A., Ahmed, M. M., Farouk, R. R., Mousa, A. M. A., & Wahab, W. M. A. E. (2024) · Research Square · doi:10.21203/rs.3.rs-4725679/v1
Measuring Cardiovascular Function in Intact Experimental Models
Lewis, A. A., Campen, M. J., & Farraj, A. K. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-95488-4.00198-4
Abdulmoniem, R., Rivers, M., Carter, G., Khundmiri, S. J., & O’Neil, J. N. (2026) · NeuroSci · doi:10.3390/neurosci7020043
- Authors
- Van Vliet, B. N., & Montani, J.-P.
- Affiliations
- University of Fribourg (CH)
- Venue
- International Journal of Obesity
- Published
- 2008-12-01
- Volume
- 32
- Issue
- S6
- Pages
- S35-S47
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2066588394
- Cited by
- 44
- References
- 108
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 6 · 2013: 3 · 2012: 2
- FWCI
- 0.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Canada
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- salt-induced hypertension, dietary salt, salt sensitivity, blood pressure response, salt restriction, hypertension epidemiology
- MeSH terms
- Adult, Age Factors, Aged, Animals, Blood Pressure, Chickens, Dogs, Female, Humans, Hypertension, Male, Middle Aged, Primates, Rabbits, Swine, Time Factors, Rats, Sprague-Dawley, Sodium Chloride, Dietary, Rats, Inbred Dahl, Mice, Rats, Young Adult
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