Serum Sodium and Pulse Pressure in SPRINT

SPRINT Research Group

Research output: Contribution to journalArticle

Abstract

BACKGROUND: High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure. Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS: Multivariable linear regression was used to examine the association between baseline serum sodium level and (i) pulse pressure (PP; n = 8,813; a surrogate measure of arterial stiffness) and (ii) carotid-femoral pulse wave velocity (CFPWV; n = 591 in an ancillary study to SPRINT). RESULTS: Baseline mean ± SD age was 68 ± 9 years and serum sodium level was 140 ± 2 mmol/L. In the PP analysis, higher serum sodium was associated with increased baseline PP in the fully adjusted model (tertile 3 [≥141 mmol] vs. tertile 2 [139-140 mmol]; β = 0.87, 95% CI = 0.32 to 1.43). Results were similar in those with and without chronic kidney disease. In the ancillary study, higher baseline serum sodium was not associated with increased baseline CFPWV in the fully adjusted model (β = 0.35, 95% CI =-0.14 to 0.84). CONCLUSIONS: Among adults at high risk for cardiovascular events but free from diabetes, higher serum sodium was independently associated with baseline arterial stiffness in SPRINT, as measured by PP, but not by CFPWV. These results suggest that high serum sodium may be a marker of risk for increased PP, a surrogate index of arterial stiffness.

Original languageEnglish (US)
Pages (from-to)649-656
Number of pages8
JournalAmerican Journal of Hypertension
Volume32
Issue number7
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Sodium
Blood Pressure
Vascular Stiffness
Serum
Dietary Sodium
Pulse Wave Analysis
Thigh
Chronic Renal Insufficiency
Linear Models
Endothelial Cells

Keywords

  • blood pressure
  • CKD
  • electrolyte imbalances
  • hypernatremia
  • hypertension
  • pulse pressure
  • pulse-wave velocity

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Serum Sodium and Pulse Pressure in SPRINT. / SPRINT Research Group.

In: American Journal of Hypertension, Vol. 32, No. 7, 01.01.2019, p. 649-656.

Research output: Contribution to journalArticle

SPRINT Research Group. / Serum Sodium and Pulse Pressure in SPRINT. In: American Journal of Hypertension. 2019 ; Vol. 32, No. 7. pp. 649-656.
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abstract = "BACKGROUND: High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure. Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS: Multivariable linear regression was used to examine the association between baseline serum sodium level and (i) pulse pressure (PP; n = 8,813; a surrogate measure of arterial stiffness) and (ii) carotid-femoral pulse wave velocity (CFPWV; n = 591 in an ancillary study to SPRINT). RESULTS: Baseline mean ± SD age was 68 ± 9 years and serum sodium level was 140 ± 2 mmol/L. In the PP analysis, higher serum sodium was associated with increased baseline PP in the fully adjusted model (tertile 3 [≥141 mmol] vs. tertile 2 [139-140 mmol]; β = 0.87, 95{\%} CI = 0.32 to 1.43). Results were similar in those with and without chronic kidney disease. In the ancillary study, higher baseline serum sodium was not associated with increased baseline CFPWV in the fully adjusted model (β = 0.35, 95{\%} CI =-0.14 to 0.84). CONCLUSIONS: Among adults at high risk for cardiovascular events but free from diabetes, higher serum sodium was independently associated with baseline arterial stiffness in SPRINT, as measured by PP, but not by CFPWV. These results suggest that high serum sodium may be a marker of risk for increased PP, a surrogate index of arterial stiffness.",
keywords = "blood pressure, CKD, electrolyte imbalances, hypernatremia, hypertension, pulse pressure, pulse-wave velocity",
author = "{SPRINT Research Group} and Nowak, {Kristen L.} and Michel Chonchol and Anna Jovanovich and Zhiying You and Jeffrey Bates and Capri Foy and Stephen Glasser and Killeen, {Anthony A.} and John Kostis and Rodriguez, {Carlos J.} and Mark Segal and Simmons, {Debra L.} and Addison Taylor and Lovato, {Laura C.} and Ambrosius, {Walter T.} and Supiano, {Mark A.}",
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T1 - Serum Sodium and Pulse Pressure in SPRINT

AU - SPRINT Research Group

AU - Nowak, Kristen L.

AU - Chonchol, Michel

AU - Jovanovich, Anna

AU - You, Zhiying

AU - Bates, Jeffrey

AU - Foy, Capri

AU - Glasser, Stephen

AU - Killeen, Anthony A.

AU - Kostis, John

AU - Rodriguez, Carlos J.

AU - Segal, Mark

AU - Simmons, Debra L.

AU - Taylor, Addison

AU - Lovato, Laura C.

AU - Ambrosius, Walter T.

AU - Supiano, Mark A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BACKGROUND: High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure. Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS: Multivariable linear regression was used to examine the association between baseline serum sodium level and (i) pulse pressure (PP; n = 8,813; a surrogate measure of arterial stiffness) and (ii) carotid-femoral pulse wave velocity (CFPWV; n = 591 in an ancillary study to SPRINT). RESULTS: Baseline mean ± SD age was 68 ± 9 years and serum sodium level was 140 ± 2 mmol/L. In the PP analysis, higher serum sodium was associated with increased baseline PP in the fully adjusted model (tertile 3 [≥141 mmol] vs. tertile 2 [139-140 mmol]; β = 0.87, 95% CI = 0.32 to 1.43). Results were similar in those with and without chronic kidney disease. In the ancillary study, higher baseline serum sodium was not associated with increased baseline CFPWV in the fully adjusted model (β = 0.35, 95% CI =-0.14 to 0.84). CONCLUSIONS: Among adults at high risk for cardiovascular events but free from diabetes, higher serum sodium was independently associated with baseline arterial stiffness in SPRINT, as measured by PP, but not by CFPWV. These results suggest that high serum sodium may be a marker of risk for increased PP, a surrogate index of arterial stiffness.

AB - BACKGROUND: High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure. Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS: Multivariable linear regression was used to examine the association between baseline serum sodium level and (i) pulse pressure (PP; n = 8,813; a surrogate measure of arterial stiffness) and (ii) carotid-femoral pulse wave velocity (CFPWV; n = 591 in an ancillary study to SPRINT). RESULTS: Baseline mean ± SD age was 68 ± 9 years and serum sodium level was 140 ± 2 mmol/L. In the PP analysis, higher serum sodium was associated with increased baseline PP in the fully adjusted model (tertile 3 [≥141 mmol] vs. tertile 2 [139-140 mmol]; β = 0.87, 95% CI = 0.32 to 1.43). Results were similar in those with and without chronic kidney disease. In the ancillary study, higher baseline serum sodium was not associated with increased baseline CFPWV in the fully adjusted model (β = 0.35, 95% CI =-0.14 to 0.84). CONCLUSIONS: Among adults at high risk for cardiovascular events but free from diabetes, higher serum sodium was independently associated with baseline arterial stiffness in SPRINT, as measured by PP, but not by CFPWV. These results suggest that high serum sodium may be a marker of risk for increased PP, a surrogate index of arterial stiffness.

KW - blood pressure

KW - CKD

KW - electrolyte imbalances

KW - hypernatremia

KW - hypertension

KW - pulse pressure

KW - pulse-wave velocity

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