Abstract

Background: In subjects who are in sodium (Na) balance, chronically increased night:day urinary Na excretion ratio is associated with arterial stiffening and nocturnal blood pressure non-dipping; less is known about these relationships following acute Na loading. Methods: We studied 11 young (24±5 yrs, 8 male/3 female), non obese, otherwise healthy prehypertensives over 6 days. Subjects ate a 20 mMol Na diet for 4 days. On day 5, they received 2 liters of 0.9% saline (308 mMol Na) over 2 hours, then an additional 130 mMol Na over 2 meals. Between days 4 and 6, subjects performed complete urine collections and ambulatory blood pressure monitoring, and underwent SphygmoCor assessment of aortic augmentation index (AIx75; in %, standardized to heart rate 75) on days 4 and 6. We defined the increase in nighttime urinary Na excretion following Na loading as: Nighttime-Na Excretion Ratio (NNER) = mMol Na/hr (rate night 5, post-Na load)/mMol Na/hr (rate night 4, pre-Na load). We also defined the change in nocturnal blood pressure dipping between night 4 (pre-Na load) and night 5 (post-Na load) as: ChgDip = nocturnal decrease in mean arterial pressure [mmHg, night 4] - nocturnal decrease in mean arterial pressure [mmHg, night 5] We then explored how the NNER related to ChgDip and AIx75 post-Na loading with linear regression. Results: The nighttime Na excretion rate increased following Na loading (.9±.9 to 8±4 mMol/hr, p < .001); the mean NNER was 13±9. After stepwise regression including age, gender, body mass index, daytime Na excretion, post-Na mean arterial pressure, and pre-Na blood pressure dip, higher NNER predicted less effect of Na loading on ChgDip ( β = −0.4, p = .005). In a stepwise regression model including age, gender, height, mean arterial pressure, left ventricular mass, aortic augmentation index in low-Na balance, and daytime Na excretion, the NNER was the only significant predictor of post-Na loading AIx75 ( β = −1.3, p= .009). Blood pressure dipping and AIx75 did not correlate with daytime Na excretion. Conclusions : Following an acute Na load, prehypertensive subjects who increase their nighttime Na excretion rate the most preserve nocturnal blood pressure dipping and have lower aortic augmentation index.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.