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Dietary sodium and nocturnal blood pressure dipping in normotensive men and women

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Abstract

Impaired nocturnal blood pressure (BP) dipping (i.e., <10% decline in nocturnal BP) is associated with an increased risk of cerebrovascular and cardiovascular diseases. Excess sodium has been shown to impair BP regulation and increase cardiovascular disease risk, yet few studies have assessed the influence of dietary sodium on nocturnal dipping in normotensive adults. The purpose of this study was to determine the effects of dietary sodium on BP dipping in normotensive men and women. Eighty healthy normotensive adults participated in a controlled feeding study (men: n=39, 34±2 years; women: n=41, 41±2 years). Participants consumed a standardized run-in 100 mmol sodium per day diet for 7 days, followed by 7 days of low-sodium (LS; 20 mmol per day) and high-sodium (HS; 300 mmol per day) diets in random order. On the final day of each diet, subjects wore a 24 h ambulatory BP monitor, collected a 24 h urine sample and provided a blood sample. During the run-in diet, 24 h urinary sodium excretion was 79.4±5.1 mmol per 24 h in men and 85.3±5.5 mmol per 24 h in women (P>0.05). Systolic BP dipping was not different between men (11.4±1.0%) and women (11.2±0.9%); (P>0.05). During the HS diet, 24 h urinary sodium excretion increased compared with the LS diet in men (LS=31.7±4.6 mmol per 24 h vs HS=235.0±13.9 mmol per 24 h, P<0.01) and women (LS=25.8±2.2 mmol per 24 h vs HS=234.7±13.8 mmol per 24 h, P<0.01). Despite this large increase in sodium intake and excretion, systolic BP dipping was not blunted in men (LS=8.9±1.0% vs HS=9.4±1.2%, P>0.05) or women (LS=10.3±0.8% vs HS=10.5±0.8%, P>0.05). Among normotensive men and women, HS does not blunt nocturnal BP dipping.

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Acknowledgements

We thank Ryan Polig, PhD, Paul Kolm, PhD, Allen Prettyman, PhD, FNP-BC, Katherine Masso, BS, Meghan Ramick, BS, Bryce Muth, MS, Alyssa Vogel, BS, and the dietitians at the Eugene du Pont Preventive Medicine and Rehabilitation Institute for their assistance with this study. This research was funded by NIH grant: R01-HL104106.

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Correspondence to D G Edwards or W B Farquhar.

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Brian, M., Dalpiaz, A., Matthews, E. et al. Dietary sodium and nocturnal blood pressure dipping in normotensive men and women. J Hum Hypertens 31, 145–150 (2017). https://doi.org/10.1038/jhh.2016.53

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