More than half of US adults have
hypertension by 40 years of age and a subsequent increase in atherosclerotic
cardiovascular disease risk.
Dietary sodium and
potassium are intricately linked to the pathophysiology of
hypertension. However, blood pressure responses to
dietary sodium and
potassium, phenomena known as
salt and
potassium sensitivity of blood pressure, respectively, are heterogenous and normally distributed in the general population. Like blood pressure,
salt and
potassium sensitivity are complex phenotypes, and previous research has shown that up to 75% of individuals experience a blood pressure change in response to such dietary minerals. Previous research has also implicated both high
salt sensitivity and low
salt sensitivity (or
salt resistance) of blood pressure to an increased risk of
hypertension and potentially atherosclerotic
cardiovascular disease risk. Given the clinical challenges required to accurately measure the
sodium and
potassium response phenotypes, genomic characterization of these traits has become of interest for
hypertension prevention initiatives on both the individual and population levels. Here, we review advances in human genomics research of blood pressure responses to
dietary sodium and
potassium by focusing on 3 main areas, including the phenotypic characterization of
salt sensitivity and resistance, clinical challenges in diagnosing such phenotypes, and the genomic mechanisms that may help to explain
salt and
potassium sensitivity and resistance. Through this process, we hope to further underline the value of leveraging genomics and broader multiomics for characterizing the blood pressure response to
sodium and
potassium to improve precision in lifestyle approaches for primordial and primary atherosclerotic
cardiovascular disease prevention.