The assessment of the relationship between blood pressure and sodium intake using whole-day, daytime and overnight urine collections

Staessen, Jan A.; Broughton, Peter; Fletcher, Astrid; Markowe, Hugh L.J.; Marmot, Michael; Rose, Geoffrey; Semmence, A.; Shipley, Martin J.; Bulpitt, Christopher J.

doi:10.1097/00004872-199111000-00009

Cited by 75 publications

(41 citation statements)

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“…40,43,[47][48][49]52 Diurnal variations in excretion of sodium, chloride, potassium, and water have been observed in many studies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Creatinine excretion has generally been reported to be fairly constant over 24 h, 2,7,11,26,28 and on average this was the case for the men in this study. Water and electrolyte excretion in healthy individuals generally reaches a maximum sometime around midday and a minimum toward the end of sleep.…”

Section: Discussionmentioning

confidence: 95%

“…In a study of 301 male British civil servants ages 37 to 58, Staessen et al 28 reported that casual SBP and DBP, measured on average 7 days earlier, were positively and significantly related to overnight sodium excretion with adjustment for age and BMI, but not to daytime or 24-h excretion. Systolic and diastolic BP were also positively related to overnight potassium excretion, but inversely to daytime and 24-h excretion.…”

Section: Discussionmentioning

confidence: 99%

“…The rationale behind this correction is that this and other studies indicate that creatinine excretion is on average constant throughout the day, 2,7,11,26,28 ie, the total amount of creatinine excreted in a 16-h daytime collection should on average be approximately twice the amount excreted in an 8-h overnight collection. Under this assumption, the creatinine term in the denominator of the second equation, ie, (2 × Cr o )/Cr d , should be close to one.…”

Section: Methodsmentioning

confidence: 99%

“…The results for creatinine are not unexpected given the relatively smaller standard deviations of the overnight to 24-hour creatinine ratios compared to those for sodium, potassium, and volume, and the finding in this and other studies that creatinine excretion is on average constant throughout the day. 2,7,11,26,28 Correlations with possible confounding variables Systolic BP was significantly correlated with age, BMI, and heart rate and DBP with BMI and heart rate ( Table 2). While SBP and DBP were positively correlated with log alcohol intake, these correlations did not differ significantly from zero.…”

Section: Descriptive Statisticsmentioning

confidence: 98%

“…A stronger association between blood pressure (BP) and overnight excretion of sodium, compared to daytime or 24-h excretion, has also been reported. 28 The present study was undertaken to further examine relations between BP level and diurnal variation in the excretion of sodium, potassium, and water.…”

Section: Introductionmentioning

confidence: 99%

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Blood pressure and diurnal variation in sodium, potassium, and water excretion

et al. 1998

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The objective of this study was to examine associations of blood pressure (BP) with ratios of overnight to 24-h urinary excretion of sodium, potassium, and water. Each of 125 men 27-64 years of age, not taking diuretics, had BP measured during the day on a Monday. Beginning Monday evening, each participant provided three carefully timed 24-h urine collections, divided into daytime and overnight (bedtime to awakening) specimens. Proportion of total 24-h excretion of sodium, potassium, and water in the overnight specimen, standardised for creatinine excretion, was determined for each 24-h period. Associations of systolic and diastolic BP (SBP/DBP) with these proportions were examined with control for age, body mass index, alcohol intake, and heart rate. Mean BP was 116/71 mm Hg; 15 men were on non-diuretic anti-hypertensive therapy. Mean 24-h urinary excretion was 168 mmol for sodium, 68 mmol for potassium, and 16 mmol for creatinine. Mean overnight

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Descriptive Statisticsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Blood pressure and diurnal variation in sodium, potassium, and water excretion

et al. 1998

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Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications (“Sleep C.A.L.M.”) in the evaluation and management of nocturia: A simple approach to a complex diagnosis

Monaghan

Weiss

Wein

et al. 2023

Neurourology and Urodynamics

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Introduction Nocturia arises from a fundamental mismatch between nocturnal urine production, storage capacity, and sleep architecture, which may be driven by abnormalities of the genitourinary tract, but also by sleep disorders, medical diseases, patient actions/lifestyle factors, or medications. This article introduces a novel system for organizing the complex differential diagnosis for nocturia, as proposed by an international collective of practicing urologists, physician specialists, and sleep experts: “Sleep CALM”—Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications. Methods Narrative review of current evidence regarding the relevance of each “Sleep CALM” factor to nocturia pathogenesis, evaluation, and management. Results Nocturia and sleep disorders are highly intertwined and often bidirectional, such that nocturnal awakenings for reasons other than a sensation of bladder fullness should not be used as grounds for exclusion from nocturia treatment, but rather leveraged to broaden therapeutic options for nocturia. Nocturia is an important potential harbinger of several serious medical conditions beyond the genitourinary tract. Urologists should have a low threshold for primary care and medical specialty referral for medical optimization, which carries the potential to significantly improve nocturnal voiding frequency in addition to overall health status. Adverse patient actions/lifestyle factors, lower urinary tract dysfunction, and medication use commonly coexist with disordered sleep and comorbid medical conditions, and may be the primary mediators of nocturia severity and treatment response, or further exacerbate nocturia severity and complicate treatment. Conclusion “Sleep CALM” provides a memorable and clinically relevant means by which to structure the initial patient history, physical exam, and clinical testing in accordance with current best‐practice guidelines for nocturia. Although not intended as an all‐encompassing diagnostic tool, the “Sleep CALM” schema may also be useful in guiding individualized ancillary testing, identifying the need for specialty referral and multidisciplinary care, and uncovering first‐line treatment targets.

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Circadian Variation of the Blood Pressure in the Population at Large

Celis¹,

Staessen²

2001

Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics

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The assessment of the relationship between blood pressure and sodium intake using whole-day, daytime and overnight urine collections

Cited by 75 publications

References 0 publications

Blood pressure and diurnal variation in sodium, potassium, and water excretion

Blood pressure and diurnal variation in sodium, potassium, and water excretion

Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications (“Sleep C.A.L.M.”) in the evaluation and management of nocturia: A simple approach to a complex diagnosis

Circadian Variation of the Blood Pressure in the Population at Large

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