Nighttime blood pressure and nocturnal dipping are associated with daytime urinary sodium excretion in african subjects

Details

Serval ID
serval:BIB_9A96D295626C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Nighttime blood pressure and nocturnal dipping are associated with daytime urinary sodium excretion in african subjects
Journal
Hypertension
Author(s)
Bankir Lise, Bochud Murielle, Maillard Marc, Bovet Pascal, Gabriel Anne, Burnier Michel
ISSN
0194-911X
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
51
Number
4
Pages
891-898
Language
english
Abstract
Blood pressure (BP) follows a circadian rhythm, with 10% to 15% lower values during nighttime than during daytime. The absence of a nocturnal BP decrease (dipping) is associated with target organ damage, but the determinants of dipping are poorly understood. We assessed whether the nighttime BP and the dipping are associated with the circadian pattern of sodium excretion. Ambulatory BP and daytime and nighttime urinary electrolyte excretion were measured simultaneously in 325 individuals of African descent from 73 families. When divided into sex-specific tertiles of day:night ratios of urinary sodium excretion rate, subjects in tertile 1 (with the lowest ratio) were 6.5 years older and had a 9.8-mm Hg higher nighttime systolic BP (SBP) and a 23% lower SBP dipping (expressed in percentage of day value) compared with subjects in tertile 3 (P for trend <0.01). After adjustment for age, the SBP difference across tertiles decreased to 5.4 mm Hg (P=0.002), and the SBP dipping difference decreased to 17% (P=0.05). A similar trend across tertiles was found with diastolic BP. In multivariate analyses, daytime urinary sodium and potassium concentrations were independently associated with nighttime SBP and SBP dipping (P<0.05 for each). These data, based on a large number of subjects, suggest that the capacity to excrete sodium during daytime is a significant determinant of nocturnal BP and dipping. This observation may help us to understand the pathophysiology and clinical consequences of nighttime BP and to develop therapeutic strategies to normalize the dipping profile in hypertensive patients.
Keywords
Adult, African Continental Ancestry Group, Blood Pressure/physiology, Circadian Rhythm/physiology, Female, Glomerular Filtration Rate/physiology, Humans, Hypertension, Renal/ethnology, Hypertension, Renal/physiopathology, Hypertension, Renal/urine, Male, Middle Aged, Potassium/urine, Risk Factors, Seychelles/epidemiology, Sodium/urine
Pubmed
Web of science
Open Access
Yes
Create date
05/05/2008 14:00
Last modification date
20/08/2019 15:01
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