A prospective study of sodium-lithium countertransport and hypertension in Utah

Steven Hunt, Susan H. Stephenson, Paul N. Hopkins, Sandra J. Hasstedt, Roger R. Williams

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A 7-year prospective study of a cohort of 1,458 normotensive adults from Utah pedigrees, screened from 1980 to 1985, was done to determine whether baseline levels of sodium-lithium countertransport were associated with an increased risk of future hypertension. Subsequent new hypertension (n=39) was ascertained in 1989 from detailed follow-up medical questionnaires (67% response). Previous segregation analyses on a subset of these pedigree members who responded (R =342) using family relationships in addition to countertransport levels have shown statistically inferred major gene segregation of sodium-lithium countertransport levels. In the normotensive adults inferred by segregation analysis to carry the recessive major gene for high sodium-lithium countertransport, new-onset hypertension occurred in 18.8% (3 of 16) compared with 3.7% (12 of 326) in the low sodium-lithium countertransport genotype group (relative risk, 4.6 [1.6, 13.9]; p=0.03). However, an elevated baseline sodium-lithium countertransport level without genotype information from segregation analysis did not increase the risk of future hypertension in the complete cohort of adult pedigree members (relative risk, 1.02 [0.85, 1.22]). Adjustment for other risk factors reduced the relative risk to 0.90 (0.72, 1.11). We conclude that the presence of a major gene for sodium-lithium countertransport or another closely linked gene, rather than the actual level of sodium-lithium countertransport, may increase the risk of hypertension onset. High sodium-lithium countertransport levels do not increase the risk of future hypertension for individuals in whom only polygenic and environmental effects determine sodium-lithium countertransport level. Both longer follow-up to increase the number of events and studies in other populations are needed to verify these results. Further characterization of the biochemical and molecular nature of the underlying recessive gene trait is needed to understand how it may increase the risk of hypertension.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
Issue number1
Publication statusPublished - Jan 1991
Externally publishedYes



  • Blood pressure
  • Epidemiology
  • Genetics
  • Red blood cells

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Hunt, S., Stephenson, S. H., Hopkins, P. N., Hasstedt, S. J., & Williams, R. R. (1991). A prospective study of sodium-lithium countertransport and hypertension in Utah. Hypertension, 17(1), 1-7.