©2016 by UVa Health System. Division of Endocrinology.

Resources for Physicians

Hypertension is highly prevalent in the American population, affecting almost a third of people who live in this country. Physicians have helped patients manage hypertension with medication, dietary changes, and lifestyle modifications. However, the current management strategies available are not as effective as we would hope. The labs of Principal Investigators Dr. Robert Carey and Dr. Robert Felder at UVA are working to help inform care for these patients through their collaborative research.

 

While continuing to learn more about the underlying causes of hypertension, our current Salt Study takes a potential genetic component of blood pressure change into account. We are studying specific genes that directly contribute to salt sensitivity, a risk factor for cardiovascular events independent from hypertension. In following with the diet component of our study, learning whether or not a patient is salt sensitive will be a powerful tool in combating hypertension, stroke, heart attacks, and chronic kidney disease among other health complications.

 

As a quick summary, our study will test participants for the presence of certain polymorphisms in two genes, G-protein related kinase 4 - GRK4- and the sodium bicarbonate cotransporter - SLC4A5. The protein products of these genes act in the kidney, and certain alterations in these genes are associated with salt sensitivity. Please see our scientific background page for more detailed information.

 

If certain polymorphisms in GRK4 or SLC4A5 are present in a participant, we plan to correlate genotype with phenotype using a diet study. We provide prepared food so trial participants go through a low salt week and a high salt week diet.

Mean arterial pressure difference between the two weeks is used to determine salt sensitivity, salt resistance, or inverse salt sensitivity. 

 

From our lab, we hope to create a tool for physicians everywhere to use to help their patients discover more about their cardiovascular health.  This risk management tool uses genetic testing and trial research diets to determine salt sensitivity or resistance for a patient with or without hypertension. Based on previous studies, around 25% of Americans are salt sensitive; altering the diet of a salt sensitive patient may be an effective part of blood pressure management. In addition, some drugs are more effective for certain patients, and genetic testing can help find a more appropriate drug for a hypertensive patient.

 

We encourage you to use our risk management tool to see where your patient can make changes to lower their blood pressure.

Genetic testing for GRK4 and SLC4A5 variants can be done through Hypogen.

The rationale for our risk calculator comes from years of background work in the field of hypertension and salt sensitivity. The papers below contain information about advances in the field of hypertension care, and we look forward to adding to this knowledge with the completion of our salt study.

The University of Virginia's Health System Department of Medicine – Division of Endocrinology and Metabolism is undergoing research to understand susceptibility of developing hypertension based on salt sensitivity of blood pressure.

Hypertension is a leading problem in our nation. Our team is dedicated to understanding and providing a more concise treatment for hypertensive patients. Many are unaware of salt sensitivity of blood pressure and may be prescribing the inappropriate medication. Our goal is to make physicians aware and conceive a blueprint for diagnosis.