Assessment of Hydration Status and Blood Pressure in a Tertiary Care Hospital at Al-Khobar

Abstract

BackgroundHigh blood pressure is a major cardiovascular risk factor. It is a leading cause of increasing morbidity and mortality worldwide. One-third of the adult population worldwide suffers from hypertension. Salt intake, obesity, decreased physical activity, and smoking are well known to increase blood pressure. Fluid retention is the main contributing factor to primary hypertension and adversely affects the cardiovascular system. The emerging evidence suggests a relationship between blood pressure and hydration status. Our study aims to assess the correlation between hydration status and blood pressure. We aim to assess the hydration status in subjects with normal and high blood pressure and to investigate the association of hydration status with hemodynamic measurement. MethodologyThis cross-sectional and observational study included adult (>18 years) male and female subjects who agreed to participate. In total, 235 subjects were recruited by convenience sampling from (1) patients and caregivers attending geriatric and internal medicine clinics, and (2) visitors coming to King Fahad University Hospital at Al-Khobar. There were five patients on oral diuretics who were excluded from the study. Data were collected from September 2021 to March 2022. Hydration status was measured by a bioelectrical impedance analyzer (Bioscan 920, Maltron International Ltd. Rayleigh, UK). Hemodynamic measurements included heart rate per minute, systolic blood pressure, diastolic blood pressure, pulse pressure (the difference between systolic and diastolic blood pressure), and mean arterial pressure calculated as blood diastolic pressure plus one-third of pulse pressure. Statistical analyses were performed using SPSS statistics for windows, version 28.0 (IBM Corp., Armonk, NY, USA). Descriptive data were reported using means with standard deviations for numerical data and relative frequencies (percentage) for categorical data. P-values of less than 0.05 were considered statistically significant. Comparison between groups was done using a oneway analysis of variance test. ResultsExtracellular water percentage was higher in hypertensive (45.0 ± 2) than prehypertensive (43.5 ± 3) or normotensive (43.0 ± 2) (p = 0.001) subjects. In contrast, intracellular water percentage and total body water percentage were significantly negatively related to hypertension status. ConclusionsOur results have shown a strong association between hypertension status and hydration parameters. In our study, hypertensive subjects tended to have lower total body water percentage and intracellular water percentage (bioimpedance value) than normotensive subjects. This might promote more research regarding the relationship between hypohydration and cardiovascular disease pathophysiology. This outcome should raise awareness about proper hydration as hypohydration can be a causative factor for hypertension.

Association between Biochemical Parameters, Especially Hydration Status and Dietary Patterns, and Metabolic Alterations in Polish Adults with Metabolic Syndrome

“…Furthermore, fluid retention is known to have adverse effects on the cardiovascular system independent of blood pressure levels. Mohammedin et al [18] found a strong association between hypertension status and hydration parameters. Hypertensive subjects tended to have a lower percentage of total body water (bioimpedance value) than normotensive subjects.…”

“…Emerging evidence suggests an association between blood pressure and hydration status. Fluid retention is a major contributor to essential hypertension and adversely affects the cardiovascular system [17][18][19]. This is of concern as cardiovascular disease is the leading cause of death worldwide.…”

Conflicting Associations among Bioelectrical Impedance and Cardiometabolic Health Parameters in Young White and Black Adults

“…Thus, large shifts in ECF volume during aging may decrease R without proportional declines in Xc, resulting in elevated BP at higher PhA. Considering that overall hydration status is known to be positively associated with systemic BP (34), these data may indicate that the relationship between PhA and BP is mediated by an overall increase in TBWa that favors an increase in ICFa over ECFa in young adults, although studies conducted in middle-aged adults have reported in similar fashion (35). Therefore, these findings should only be generalized to young adults at risk of cardiometabolic disease, and it may be possible that the inverse association between PhA and BP reverses throughout the aging process.…”