The Relationship Between Cognitive Function, Depressive Behaviour and Sleep Quality with 24-h Urinary Sodium Excretion in Patients with Essential Hypertension

Abstract

Various studies have shown that sodium intake is related to increased blood pressure. However, the relationship between sodium intake and cognitive function and depression has not previously been studied. The objective of this study was to investigate the relationship between 24-h sodium excretion with cognitive function, depression and sleep quality in patients newly diagnosed with essential hypertension. All patients underwent history taking, physical examination, blood pressure measurement, 12-lead ECG evaluation, routine urine analysis, biochemical analysis and 24-h urine collection to measure urinary sodium and protein excretion and creatinine clearance, evaluation of cognitive function, depressive behaviour and sleep quality. In total, 119 patients newly diagnosed with essential hypertension (50 men and 69 women aged 54.2±16.1years) were enrolled. The 24-h urinary sodium excretion of the patients was 204.0±240.4mEq/day. The Standardized Mini Mental State Examination (SMMSE), Pittsburgh Sleep Quality Index and Beck Depression Inventory scores of the patients were 26.0±2.7, 5.6±3.1 and 21.6±13.5, respectively. Spearman correlation analysis revealed that 24-h urinary sodium excretion was correlated with age (rho -0.258, p=0.005), systolic blood pressure (rho 0.219, p=0.017), diastolic blood pressure (rho 0.195, p=0.034), creatinine clearance (rho 0.414, p<0.0001) and SMMSE score (rho -0.257, p=0.005). Stepwise linear regression of independent factors revealed that gender (p<0.0001), creatinine clearance (p<0.0001), systolic blood pressure (p=0.031) and SMMSE score (p<0.0001) were independently related to logarithmically converted 24-h sodium excretion. The current study demonstrated that better cognitive function, but not depressive behaviour and sleep disturbance, is related to decreased sodium intake as evaluated by 24-h urinary sodium excretion. Studies are needed to highlight the mechanisms regarding the relationship between cognitive function and sodium intake.