There are clear differences between men and women, and differences among races, in the incidence and prevalence of hypertension. Furthermore, there is extensive inter-individual variability among humans in the extent to which sodium ingestion alters blood pressure. Orthostatic intolerance and orthostatic hypotension are more common in women; these are often treated with a high salt diet, which has variable efficacy in increasing blood volume and blood pressure. Conversely, people with certain forms of hypertension are often counseled to decrease their sodium intake. Non-Hispanic Black men and women have higher rates of hypertension compared to non-Hispanic White men and women and other racial/ethnic groups. In aggregate, Black women appear to have better orthostatic tolerance than White women. In the present paper, we summarize and evaluate the current evidence for mechanisms of blood pressure regulation in men and women, as well as differences between Black and White groups, with a focus on cardiovascular responses to salt and differences among these groups. We also provide a brief review of factors that are not traditionally considered to be “biological” – such as socio-economic disparities resulting from historic and contemporary inequity across racial groups. These non-biological factors have direct and substantial influences on cardiovascular mechanisms, as well as implications for the influences of salt and sodium intake on blood pressure and cardiovascular health. We conclude that both biological and socio-economic factors provide critical modulating influences when considering the impacts of sodium on cardiovascular health as functions of race and sex.

男性和女性之间以及种族之间的高血压发病率和患病率存在​​明显差异。此外，钠摄入改变血压的程度存在广泛的个体差异。直立性不耐受和直立性低血压在女性中更为常见；这些疾病通常采用高盐饮食来治疗，这种饮食在增加血容量和血压方面具有不同的功效。相反，患有某些高血压的人通常会被建议减少钠的摄入量。与非西班牙裔白人男性和女性以及其他种族/族裔群体相比，非西班牙裔黑人男性和女性的高血压发病率更高。总的来说，黑人女性似乎比白人女性具有更好的直立耐受性。在本文中，我们总结和评估了男性和女性血压调节机制的现有证据，以及黑人和白人群体之间的差异，重点关注心血管对盐的反应以及这些群体之间的差异。我们还简要回顾了传统上不被认为是“生物学”的因素，例如历史和当代种族群体之间的不平等造成的社会经济差异。这些非生物因素对心血管机制有直接和实质性的影响，也对盐和钠的摄入对血压和心血管健康的影响有影响。我们的结论是，当考虑钠对心血管健康的影响作为种族和性别的函数时，生物和社会经济因素都提供了关键的调节影响。