Abstract
Background This study investigated plasma sodium/potassium ratio, markers of oxidative stress, renal function, and endothelial dysfunction in hypertensive Nigerians. Materials and Methods Five hundred forty-nine volunteers consisting of three hundred and twenty-four hypertensive and two hundred twenty-five controls participated in this study. Blood samples were collected from the participants and were analyzed for electrolytes, markers of oxidative stress, endothelial dysfunction, renal function, and inflammation, using ion-selective electrodes, spectrophotometric, and enzyme-linked immunosorbent assay methods, respectively. Results The mean systolic blood pressure, mean diastolic blood pressure, mean arterial blood pressure, and body mass index (BMI) were significantly elevated among the hypertensive group when compared with control (p < 0.001). The mean sodium increased, while potassium and bicarbonate (HCO3−) decreased (p < 0.001) in hypertensive volunteers. The sodium-potassium ratio (Na+/K+) and urea were raised (p < 0.001) in the hypertensive group when compared with the control. Glutathione, superoxide dismutase, nitric oxide (NO), and catalase were significantly reduced (p < 0.001) while malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), and ferritin were raised significantly (p < 0.001) in hypertensive participants. The odds of hypertension and its complications increased (p < 0.001) with an increase in BMI, Na+/K+, hs-CRP, MDA, and ferritin and a decrease in estimated glomerular filtration rate (eGFR), glutathione, superoxide dismutase, and catalase. Conclusion An increase in Na+/K+, urea, hs-CRP, ferritin, MDA, and BMI and a decrease in eGFR, glutathione, and superoxide dismutase were associated with an increased risk of hypertension complication. Abnormal values of markers of oxidative stress, inflammation, and endothelial function could impact deleterious effects on the cardiovascular system among hypertensive Nigerians. A decreased bicarbonate possibly suggests an occult acid-base imbalance among hypertensive volunteers.
Highlights
Hypertension is the most common noncommunicable disease and the most prevalent cardiovascular disease risk factor worldwide. e risk of cardiovascular disease, cerebrovascular disease, and death increases progressively with each millimeter of mercury increase in blood pressure [1]
Ethical approval was obtained from the Health Research and Ethics committee (HREC), Lagos State University Teaching Hospital (LASUTH), before embarking on this study. is study was in concord with the declaration of Helsinki as informed consent was sought and obtained before participants were recruited into this study
Electrolytes were determined using an ion-selective electrode (SFR, 4000), urea and creatinine were determined using autoanalyser Cobas C-111, high sensitivity-C-reactive protein and ferritin were determined using enzyme-linked immunosorbent assay (ELISA), and haematocrit and haemoglobin were determined using Mindray 5300BC. e plasma sodium to potassium ratio was obtained through calculation
Summary
Hypertension is the most common noncommunicable disease and the most prevalent cardiovascular disease risk factor worldwide. e risk of cardiovascular disease, cerebrovascular disease, and death increases progressively with each millimeter of mercury increase in blood pressure [1]. A previous study has suggested that sodium and potassium have a significant effect on blood pressure by multiple mechanisms [5]. Interaction between sodium and potassium plays a significant role in the development of essential high blood pressure [6]. Few previous studies have demonstrated an association between sodium intake and high blood pressure [7, 8]. Us, the sodium-potassium ratio (Na+/K+) may be more associated with blood pressure outcomes than either Na+ or K+ [9, 10]. An association between sodium to potassium (Na+/K+) ratio and the incidence of high blood pressure has been reported [8, 11]. Plasma Na+/K+ might provide additional information towards the effective management of high blood pressure. This study evaluated the plasma Na+/K+ ratio among Nigerian hypertensive volunteers
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