Validation of the Detection of The Salt Sensitivity of Blood Pressure from 24-hour Ambulatory Blood Pressure Monitoring Data.

Authors

Xiangyu Zheng, Leonardo Maximo Cardoso, Christopher Dieffenthaller, Arshed A Quyyumi, Puja K Mehta, Richard D Wainford

Published in

American journal of physiology. Heart and circulatory physiology. Aug 18, 2026. Epub Aug 18, 2026.

Abstract

The salt sensitivity of blood pressure (SSBP) is rarely assessed and represents a critical barrier in precision hypertension treatment. The current approaches to assess salt sensitivity are labor and resource intensive limiting their clinical implementation. The salt sensitivity index (SSI), derived from 24-hour ambulatory blood pressure monitoring (ABPM) data, has been proposed as a clinical diagnostic approach to classify individuals at low-, intermediate-, or high-risk for the SSBP. This study utilized the Dietary Approaches to Stop Hypertension (DASH)-Sodium Trial control diet arm dataset (N=170), in which the SSBP was assessed by the gold standard dietary approach, to address the hypothesis that identification of a high-risk SSI can predict the individual SSBP. In the high-risk SSI category 72% of DASH-Sodium Trial participants exhibited a salt-sensitive phenotype. For all participants with a high-risk SSI (male and female and normotensive and hypertensive) sensitivity (ability to correctly identify individuals with the SSBP) was 85%, specificity (ability to correctly identify individuals without the SSBP) was 41%, positive predictive value (probability that a person who tests positive has the SSBP) was 72%, negative predictive value was 60% (probability that a person who tests negative does not have the SSBP) and accuracy was 69%. For hypertensive participants only with a high-risk SSI (males and females), sensitivity was 86%, specificity was 44%, the positive predictive value increased to 83%, the negative predictive value was 50% and accuracy increased to 76%. This study validates the identification of a high-risk SSI, based on 24-hour ABPM, as a generalizable implementable approach for the clinical diagnosis of the SSBP, with a potential greater clinical diagnostic value in hypertensive versus normotensive individuals.

PMID:
42613149
Bibliographic data and abstract were imported from PubMed on 19 Aug 2026.

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