Novel Findings Related to HTN

Question 1

Nonosmotic sodium storage in the skin

Answer 1

Tissue sodium is higher in hypertensive patients compared with controls, and highest among those with treatment-resistant HTN.

Question 2

Nonosmotic sodium storage in the skin

Answer 2

Tissue sodium decreases in patients with primary aldosteronism following adrenalectomy or treatment with spironolactone.

Question 3

Nonosmotic sodium storage in the skin

Answer 3

Patients with resistant HTN treated with spironolactone had sodium content levels similar to those of normotensive patients.

Question 4

Epithelial sodium channel (ENaC) and endothelial stiffness

Answer 4

ENaC is expressed in several nonepithelial tissues including vascular endothelium.

Question 5

Epithelial sodium channel (ENaC) and endothelial stiffness

Answer 5

Conditions associated with increased ENaC expression (e.g., experimental model of Liddle syndrome, aldosterone stimulation) are associated with increased endothelial cell stiffness.

Question 6

Epithelial sodium channel (ENaC) and endothelial stiffness

Answer 6

Conditions associated with reduced ENaC (ENaC knockdown, spironolactone, amiloride) lead to significant reductions in endothelial stiffness.

Question 7

Epithelial sodium channel (ENaC) and endothelial stiffness

Answer 7

Future direction: vascular-specific ENaC inhibition to lower BP, reduce atherosclerosis without hyperkalemic effect

Question 8

Gut microbiota and HTN

Answer 8

Olfactory receptors in large arteries in the kidney (and elsewhere in the body) may sense short-chain fatty acid production by gut bacteria and induce a vasodilatory and hypotensive effect.