Could salt intake directly affect the cerebral microvasculature in hypertension?

Ana Monteiro*, Pedro Castro, Gilberto Pereira, Carmen Ferreira, Cristina Duque, Farzaneh Sorond, Andrew Milstead, James P. Higgins, Jorge Polónia, Elsa Azevedo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: Excess dietary salt and chronic kidney disease (CKD) are acknowledged stroke risk factors. The development of small vessel disease, similarly affecting the cerebral and renal microvasculatures, may be an important mechanistic link underlying this interaction. Therefore, we aimed to evaluate if the dietary salt intake and markers of CKD (estimated glomerular filtration rate, albuminuria) relate to transcranial Doppler (TCD) markers of cerebral small vessel disease (CSVD) in hypertensive patients. Materials and methods: Fifty-six hypertensive patients (57% with diabetes) underwent TCD monitoring in the middle (MCA) and posterior (PCA) cerebral arteries for evaluating neurovascular coupling (NVC), dynamic cerebral autoregulation (dCA), and vasoreactivity to carbon dioxide (VRCO2). We investigated the relation between renal parameters and TCD studies using Pearson's correlation coefficient and linear regression analyses. Results: There were no associations between dCA, VRCO2, NVC, and renal function tests. However, there was a negative association between the daily salt intake and the natural frequency during visual stimulation (r2=0.101, ß=-0.340, p=0.035), indicative of increased rigidity of the cerebral resistance vessels that react to cognitive activation. Conclusions: In this cross-sectional study, we found an association between excess dietary salt consumption and CSVD in hypertensive patients. Future research is needed to evaluate whether the natural frequency could be an early, non-invasive, surrogate marker for microvascular dysfunction in hypertension.

Original languageEnglish (US)
Article number106632
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number9
StatePublished - Sep 2022


  • Cerebral small vessel disease
  • Diabetes mellitus
  • Dynamic cerebral autoregulation
  • Hypertension
  • Neurovascular coupling
  • Salt Intake
  • Vasoreactivity

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Rehabilitation
  • Surgery


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