Is there a greater sensitivity to salt in women?

Key messages

Sodium sensitive blood pressure (salt-sensitive blood pressure, SSBP) occurs when blood pressure rises or decreases by more than 10% in response to dietary salt intake. It is a pathophysiological condition, partly hereditary, which involves 50 to 80% of hypertension diagnoses.
• The main results reported by a review published in Hypertension shows that women, of all ages and of various ethnicities, are united by a greater sensitivity to sodium with consequent blood pressure effects.  
• Menopausal patients appear to be more susceptible to SSBP.This suggests that the sex chromosome predisposes to SSBP, while female hormones tend to mitigate its effects.

Why it’s important

• Numerous clinical and population studies show that women, compared to men, have a greater sensitivity to dietary salt. However, the molecular mechanisms underlying this difference are unknown.
• Studies on gender differences in medicine are in full development. Biological sex, sex hormones and a genetic predisposition affect the mechanism and development of SSBP.
• The dogma that premenopausal women are more resilient to heart and vascular disease is spreading thanks to the protection offered in large part by sex hormones.

How the study was conducted

• Studies in both rodents and humans were considered.Only in recent years have female counterparts also been taken into account.
• In the studies considered, there are patients from numerous countries (China, US, France, Spain, Mexico,), of different ethnicities (whites, blacks, Asian, Americans and Asians) and of both genders (males and females). To this are added more than 10 thousand patients from 32 countries of the INTERSALT study (International Study of Sodium, Potassium, and Blood Pressure).

Main results

• Women are more sensitive to salt than men and more likely to develop SSBP.
• SSBP changes throughout a woman’s lifespan and is independent of ethnicity.
• A key contribution is provided by inappropriate activation of the renin-angiotensin-aldosterone axis that induces vascular dysfunction in women. In particular, the combination of high expression of mineralocorticoid receptors, activation of endothelial sodium channels and increased adrenal response to angiotensin II induce endothelial dysfunction resulting in SSBP.

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Source — https://www.univadis.it/viewarticle/esiste-una-maggiore-sensibilit%25C3%25A0-al-sale-nelle-donne-2023a10005dd