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Hypertension Research Network

Work-packages 6: Vascular Function

WP6. Evaluation of vascular function in hypertensive patients

PD Dr. Isabella Sudano, Dr Jens Barthelmes, PD Dr Andreas J. Flammer

Endothelial dysfunction in all vascular beds has been appreciated as a hallmark of hypertension. Similarly, well buttressed by epidemiological and experimental data is an association of salt intake and hypertension. Nonetheless, salt sensitivity in terms of hypertensive reaction varies considerably between individual patients. The traditionally accepted physiological models of salt/water-homeostasis predict that chronic high dietary sodium intake results in the increase of the total extracellular space and body mass. In this classical model, hypertension is thought to depend crucially on the renal impairment in excreting sodium. However, recent evidence shows the presence of biorhythmic accumulation and release of body sodium probably driven by endocrine clocks. This biorhythmic “sodium tide” is not paralleled by changes in body weight due to water accumulation. Moreover, sodium content can rise in local patterns (e. g. in muscular cells) but not in vascular/endothelial cells, or rather restrict to skin interstitial cells. Indeed, there is growing evidence of an association between non-osmotic salt accumulation in the skin interstitium and endothelial dysfunction.
This work-package aims at investigating the relationship between vascular function and regulation of non-osmotic sodium reservoirs in hypertensive patients.