Cardiovascular events occur more frequently in
sodium-sensitive patients with
essential hypertension; recently,
sodium sensitivity was shown to be a cardiovascular risk factor independently of other classic factors such as blood pressure and cigarette smoking This study examined the relationship between
salt sensitivity status and target organ damage in hypertensive patients. Ninety-six patients (35 men, 61 women) with moderate
essential hypertension were studied for
salt sensitivity status and the presence of target organ damage, including
hypertensive retinopathy, serum
creatinine,
creatinine clearance, and urinary
albumin excretion (UAE). Four different patterns of left ventricular anatomic adaptation were identified by categorizing patients according to the values of left ventricular mass index and relative wall thickness by the means of echocardiography. Forty-five (47%) patients were shown to be
salt-sensitive, in contrast to 51 (53%)
salt-resistant subjects. Serum
creatinine and UAE were significantly higher in the group of
salt-sensitive hypertensives (P < .05 and P < .001, respectively). Left ventricular mass index (LVMI), relative wall thickness (RWT), and left atrial index (LAI) were all significantly higher in the group of
salt-sensitive hypertensive patients. Concentric
hypertrophy was significantly more prevalent in the
salt-sensitive group (37.8% v 11.8%; P < .01). The prevalence of
hypertensive retinopathy in the
salt-sensitive group was 84.4%, in contrast to 59.6% in the
salt-resistant group (P < .01). Multivariate regression analysis revealed
salt sensitivity as a significant predictor of LVMI, RWT, and UAE, independently of age, body mass index, and mean blood pressure. In conclusion,
salt-sensitive hypertensive patients are more prone to develop severe hypertensive target organ damage that may enhance their risk of renal and cardiovascular morbidity.