Fructose, salt and high blood pressure in rats
What it found
In rats, a diet high in fructose and salt raised blood pressure through effects on the kidneys and the nerves that supply them.
The paper also reports that people who drink sugar-sweetened beverages have a 12% greater risk of high blood pressure.
What they found
Studies in people
Sugar drinks and risk
A meta-analysis of 240,508 people found a 12% greater risk of high blood pressure with consumption of sugar-sweetened beverages, after accounting for sex, age, race, BMI and smoking. The authors note this risk is smaller than that from alcohol, smoking, red meat or a sedentary lifestyle, but still real.
Animal and lab studies
Fructose and sodium balance
Rats given 20% fructose in their drinking water and a high salt diet retained more sodium than rats given water or glucose. This positive sodium balance was linked to higher blood pressure.
Kidney sodium handling
In rats and lab tests, fructose increased the activity of sodium transporters in the kidney, including NHE3 and NKCC2. This led to more sodium and fluid being reabsorbed, which can raise blood pressure.
Renin and angiotensin
In fructose-fed rats on high salt, the usual suppression of renin was blunted, and the kidney became more sensitive to angiotensin II. This further increased sodium reabsorption.
Kidney nerves
Rats on 20% fructose and high salt showed a 41% increase in renal sympathetic nerve activity after one week. Cutting the kidney nerves lowered blood pressure and improved insulin sensitivity.
Two-phase blood pressure rise
In rats, fructose and high salt first raised blood pressure through renin and sodium retention. After two to three weeks, renin fell and the kidney nerves took over to keep blood pressure high.
What the authors conclude
“Thus, combined fructose and high salt diets may lead to hypertension and increased cardiovascular risks even short term and in individuals without the full metabolic syndrome.”
Also in their conclusions
- They conclude that high fructose and salt intakes contribute to the increased incidence and prevalence of hypertension in the U.S. and globally.
- They state that combined fructose and high salt diets may lead to hypertension and increased cardiovascular risks even short term and in individuals without the full metabolic syndrome.
- They suggest that fructose-induced enhancement of renal sodium reabsorption with greater positive net cumulative sodium balance can lead to elevations of blood pressure.
How it was done
The authors wanted to understand how diet, especially fructose and salt, contributes to high blood pressure, since most cases have no known cause and fructose consumption rose sharply alongside rising rates of high blood pressure.
They searched scientific databases for studies from January 1975 to January 2019 on fructose, blood pressure, sodium, the kidney and the sympathetic nervous system, screening 428 articles. They included both human and animal studies.
What it can’t tell you
- Most of the detailed findings come from animal studies, so they cannot show exactly what happens in people.
- The human evidence is based on studies that follow people over time or surveys, which can show a link but not prove that fructose causes high blood pressure.
- Whether the risk of high blood pressure from fructose is changed by also eating more salt has not yet been tested in people.
Who paid
- Funding
- Funded by RRD VA; U.S. Department of Veterans Affairs (from the PubMed record).
- Conflicts
- The authors declare no conflict of interest.
- Authors work at
- Wayne State University, USA; John D. Dingell VA Medical Center, USA
The paper
- Title
- Hypertension Associated with Fructose and High Salt: Renal and Sympathetic Mechanisms
- Type
- Study
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Komnenov D, Levanovich PE, Rossi NF (2019). Hypertension Associated with Fructose and High Salt: Renal and Sympathetic Mechanisms. Nutrients. doi:10.3390/nu11030569Free full textPubMed 30866441DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error