Hypertension in African Americans: the role of sodium chloride and extracellular fluid volume.

African Americans show higher blood pressure earlier in life, and have a greater incidence of hypertension that is manifest earlier, is more severe and is associated with a greater risk of cardiovascular complications as compared with their white colleagues. Although a variety of mechanisms have been implicated in this phenomenon, a single abnormal factor is unlikely. The role of sodium (salt) sensitivity of blood pressure, renal function, related vasoactive factors, and intracellular ion transport systems will be briefly reviewed for their potential involvement. Speculative hypotheses concerning potential causes of the enhanced salt-sensitivity observed in African Americans will be offered. The implications of these findings for the treatment of hypertension in African Americans will also be briefly discussed.