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Tagawa K, Tsuru Y, Yokoi K, et al. Albuminuria Intensifies the Link Between Urinary Sodium Excretion and Central Pulse Pressure in the General Population: The Wakuya Study. Am J Hypertens. 2021;34(8):851-857doi: 10.1093/ajh/hpab057.
Tagawa, K., Tsuru, Y., Yokoi, K., Aonuma, T., & Hashimoto, J. (2021). Albuminuria Intensifies the Link Between Urinary Sodium Excretion and Central Pulse Pressure in the General Population: The Wakuya Study. American journal of hypertension, 34(8), 851-857. https://doi.org/10.1093/ajh/hpab057
Tagawa, Kaname, et al. "Albuminuria Intensifies the Link Between Urinary Sodium Excretion and Central Pulse Pressure in the General Population: The Wakuya Study." American journal of hypertension vol. 34,8 (2021): 851-857. doi: https://doi.org/10.1093/ajh/hpab057
Tagawa K, Tsuru Y, Yokoi K, Aonuma T, Hashimoto J. Albuminuria Intensifies the Link Between Urinary Sodium Excretion and Central Pulse Pressure in the General Population: The Wakuya Study. Am J Hypertens. 2021 Aug 09;34(8):851-857. doi: 10.1093/ajh/hpab057. PMID: 33893813; PMCID: PMC8385571.
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Am J Hypertens. 2021 Aug 09;34(8):851-857. doi: 10.1093/ajh/hpab057.

Albuminuria Intensifies the Link Between Urinary Sodium Excretion and Central Pulse Pressure in the General Population: The Wakuya Study.

American journal of hypertension

Kaname Tagawa, Yusuke Tsuru, Katsumi Yokoi, Takanori Aonuma, Junichiro Hashimoto

Affiliations

  1. Miyagi University of Education Medical Center, Sendai, Japan.
  2. Wakuya National Health Insurance Hospital, Miyagi, Japan.
  3. Wakuya Medical and Welfare Center, Miyagi, Japan.

PMID: 33893813 PMCID: PMC8385571 DOI: 10.1093/ajh/hpab057

Abstract

BACKGROUND: Central pulse pressure (cPP) is responsible for the hemodynamics of vital organs, and monitoring this parameter is important for cardiovascular disease (CVD) prevention. Excess sodium intake and (micro)albuminuria (a manifestation of renal microvascular damage) are known to be strong predictors of CVD. We sought to investigate the cross-sectional relationships among dietary sodium intake, albuminuria, and cPP in a general population cohort.

METHODS: The subjects were 933 apparently healthy adults (mean age, 56 ± 10 years). Radial pressure waveforms were recorded with applanation tonometry to estimate mean arterial pressure (MAP), cPP, forward and backward pressure amplitudes, and augmentation index. The urinary sodium/creatinine and albumin/creatinine ratios were measured in spot urine samples.

RESULTS: Both the urinary sodium/creatinine and albumin/creatinine ratios were positively correlated with cPP, even after adjusting for MAP (P < 0.001). Moreover, both ratios had a synergistic influence on increasing the cPP independent of age, sex, estimated glomerular filtration rate, hyperlipidemia, and diabetes (interaction P = 0.04). A similar synergistic influence was found on the forward pressure amplitude, but not on the backward pressure amplitude or augmentation index. The overall results were not altered when the urinary albumin/creatinine ratio was replaced with the existence of chronic kidney disease (CKD).

CONCLUSIONS: (Micro)albuminuria strengthens the positive association between urinary sodium excretion and cPP and systolic forward pressure. Excess sodium intake may magnify the cardiovascular risk by widening the aortic pulsatile pressure, particularly in the presence of concomitant CKD.

© The Author(s) 2021. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.

Keywords: aorta; blood pressure; chronic kidney disease; general population; hypertension; renal microvascular damage; salt intake

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