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Open AccessJournal ArticleDOI

23Na Magnetic Resonance Imaging-Determined Tissue Sodium in Healthy Subjects and Hypertensive Patients

TLDR
23Na magnetic resonance imaging could have utility in assessing the role of tissue Na+ storage for cardiovascular morbidity and mortality in longitudinal studies, and it is suggested that patients with refractory hypertension had increased tissueNa+ content, compared with normotensive controls.
Abstract
High dietary salt intake is associated with hypertension; the prevalence of salt-sensitive hypertension increases with age. We hypothesized that tissue Na(+) might accumulate in hypertensive patients and that aging might be accompanied by Na(+) deposition in tissue. We implemented (23)Na magnetic resonance imaging to measure Na(+) content of soft tissues in vivo earlier, but had not studied essential hypertension. We report on a cohort of 56 healthy control men and women, and 57 men and women with essential hypertension. The ages ranged from 22 to 90 years. (23)Na magnetic resonance imaging measurements were made at the level of the calf. We observed age-dependent increases in Na(+) content in muscle in men, whereas muscle Na(+) content did not change with age in women. We estimated water content with conventional MRI and found no age-related increases in muscle water in men, despite remarkable Na(+) accumulation, indicating water-free Na(+) storage in muscle. With increasing age, there was Na(+) deposition in the skin in both women and men; however, skin Na(+) content remained lower in women. Similarly, this sex difference was found in skin water content, which was lower in women than in men. In contrast to muscle, increasing Na(+) content was paralleled with increasing skin water content. When controlled for age, we found that patients with refractory hypertension had increased tissue Na(+) content, compared with normotensive controls. These observations suggest that (23)Na magnetic resonance imaging could have utility in assessing the role of tissue Na(+) storage for cardiovascular morbidity and mortality in longitudinal studies.

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Journal ArticleDOI

Sodium First Approach, to Reset Our Mind for Improving Management of Sodium, Water, Volume and Pressure in Hemodialysis Patients, and to Reduce Cardiovascular Burden and Improve Outcomes

TL;DR: A sodium first approach is strongly called for to reduce disease burden and improve cardiac health in dialysis-dependent chronic kidney disease patients.
Journal ArticleDOI

An observational study on intracutaneous sodium storage in intensive care patients and controls.

TL;DR: The highest amounts of both water and sodium were found in patients with sepsis, with slightly lower values after CABG and the lowest amounts in THA-controls, which leaves room for alternative explanations, including non-osmotic sodium storage.
Journal ArticleDOI

The first observation of osmotically neutral sodium accumulation in the myocardial interstitium.

TL;DR: In this paper, the authors used high-resolution X-ray fluorescence (XRF) spectromicroscopy technique to perform a comparative analysis of sodium containment in intracellular and interstitial spaces of cardiac tissues taken from animals selected by low and high sodium intake rates.
Journal ArticleDOI

Skin Sodium and Blood Pressure Regulation

Abstract: Hypertension is a major public health concern due to its high prevalence and increased risk of cardiovascular disease and mortality. Complex traits resulting from both genetic and environmental factors affect the development of hypertension. Among environmental factors, a high salt diet is an important cause for hypertension. Humans show a heterogeneous blood pressure (BP) response to sodium intake. Although the precise mechanisms for the association between salt sensitivity and hypertension have not been fully elucidated, renal sodium handling has been considered to play a pivotal role. However, this conventional view has recently been challenged in that a third compartment, namely, skin may have a role in the regulation of sodium homeostasis. Skin is comprised of a significant portion of interstitium, which is a major extracellular fluid compartment, and its complex capillary network regulates body temperature and skin perfusion. Growing evidence indicates that local regulatory action of cutaneous blood flow as well as salt and water metabolism is associated with systemic BP control. Previous experimental studies have shown that dietary salt loading resulted in nonosmotic sodium accumulation via glycosaminoglycans and lymphatics embedded in the skin that were mediated by several endogenous factors and attenuated an increase in BP. Studies in humans have also suggested that the skin serves as a buffer system for sodium storage and that skin sodium contributes to salt sensitivity and hypertension. Thus, skin sodium storage provides the possibility of being an additional buffering system in response to salt loading and concomitant BP changes in humans.
Book ChapterDOI

Hypertension as Three Systematic Dysregulations of Na + Homeostasis in Terrestrial Mammal, and Salt in Gut Might Cause Brain Inflammation

TL;DR: The DASH diet is one of the universal diets for adult human, not only by reducing salt, but also by reducing metabolic stress and improving of dysbiosis, and this article proposes that three molecular dysfunctions are involved in the development of salt-sensitive hypertension through three immunological mechanisms in the maintenance of Na+ homeostasis.
References
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Journal ArticleDOI

Prevalence of Hypertension in the US Adult Population: Results From the Third National Health and Nutrition Examination Survey, 1988-1991

TL;DR: awareness, treatment, and control of hypertension have improved substantially since the 1976-1980 National Health and Nutrition Examination Survey but continue to be suboptimal, especially in Mexican Americans.(ABSTRACT TRUNCATED AT 250 WORDS)
Journal ArticleDOI

Molecular Mechanisms of Human Hypertension

TL;DR: Supported in part by a Specialized Center of Research in Hypertension and NIH K08 awards (to A. G. and D. S. G.) and a grant from the Howard Hughes Medical Institute.
Journal ArticleDOI

Salt Sensitivity, Pulse Pressure, and Death in Normal and Hypertensive Humans

TL;DR: Long-term follow-up of normotensive salt-sensitive subjects in whom assessment of salt sensitivity of blood pressure was performed as long as 27 years ago provides unique evidence of a relationship between salt sensitivity and mortality that is independent of elevated blood pressure.
Journal ArticleDOI

Fat and water magnetic resonance imaging.

TL;DR: This article reviews the most commonly used techniques for fat suppression and fat–water imaging including 1) chemically selective fat suppression pulses “FAT‐SAT”; 2) spatial‐spectral pulses (water excitation); 3) short inversion time (TI) inversion recovery (STIR) imaging; 4) chemical shift based water–fat separation methods; and finally 5)Fat suppression and balanced steady‐state free precession (SSFP) sequences.
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