Germline Mutations Affecting Gα 11 in Hypoparathyroidism

Abstract

Although it has been difficult to separate salt need from salt preference, current levels of salt consumption exceed salt need and are associated with adverse clinical outcomes. High salt intake is associated with high blood pressure and increased rates of cardiovascular disease. Experimental studies continue to provide information about mechanisms for these adverse effects of salt. In clinical trials, a reduction in salt intake is associated with reduced blood pressure, more so in persons with hypertension than in those with normal blood pressure. Although not discussed in the present review, it should be noted that reduced salt intake is associated with greater blood-pressure responses to antihypertensive drug therapy, including drug therapy in patients with resistant hypertension.85,86 Most, but not all, clinical trials have shown that reduced salt intake is also associated with decreased risks of cardiovascular events and death. Consequently, recommendations for reducing the currently high levels of salt consumption in the general population seem justifiable, although in terms of safety, the lower limit of salt consumption has not been clearly identified. It may be premature to discount the apparently paradoxical cardiovascular outcomes associated with low salt intake, particularly in specific clinical conditions (e.g., type 1 or type 2 diabetes and congestive heart failure that is aggressively treated with diuretic agents). Less-rigorous targets for salt reduction may be appropriate for these and other patient groups.