Русский
Urine conductivity as a screening test to detect an adverse circadian blood pressure profile
A.V. Sokolova, D.O. Dragunov, G.P. Arutyunov
Aim. To develop a new marker for early screening for adverse circadian blood pressure profile.
Material and methods. The study comprised 375 patients who self-referred to the Health Centre. The mean age of the patients was 46±8 years. All patients reported salt consumption of over 6 g/day, 56% of them had abdominal obesity. «Office» BP measurements showed mean SBP 144±12.8 mm Hg and DBP 89±7 mm Hg. 36%, 19.2%, 42.4% and 2.4% of patients had «non-dipper», «night-peaker», «dipper» and «over-dipper» circadian blood pressure profiles, respectively. Urine conductivity and natriuresis were measured in a single urine sample collected in the morning (08:00–10:00), daytime (12:00–14:00) and evening (18:00–20:00) hours.
Results. The findings showed interrelationship between natriuresis and urine conductivity: correlation coefficients between natriuresis and urine conductivity in the morning, daytime and evening urine samples were r=0.987, p<0.0001, r=0.982, p<0.0001 and r=0.989, p<0.0001, respectively. Patients with «night-peaker» AD profile were found to have a sharp rise in the level of natriuresis and urine conductivity («peak»). Examining the likelihood of adverse circadian blood pressure profile depending on the «peak» of sodium excretion and urine conductivity showed that evening «peak» of natriuresis and urine conductivity increases the possibility of 24-hour «night-peaker» (to a greater extent) and «non-dipper» AD profiles.
Conclusion. Natriuresis, which reflects the functional state of renal TIT and its circadian disturbances, is able to most fully reveal the risk of adverse blood pressure profile. Screening of natriuresis by measuring urine conductivity in the evening hours allows adverse blood pressure profiles to be predicted with high
probability.
Material and methods. The study comprised 375 patients who self-referred to the Health Centre. The mean age of the patients was 46±8 years. All patients reported salt consumption of over 6 g/day, 56% of them had abdominal obesity. «Office» BP measurements showed mean SBP 144±12.8 mm Hg and DBP 89±7 mm Hg. 36%, 19.2%, 42.4% and 2.4% of patients had «non-dipper», «night-peaker», «dipper» and «over-dipper» circadian blood pressure profiles, respectively. Urine conductivity and natriuresis were measured in a single urine sample collected in the morning (08:00–10:00), daytime (12:00–14:00) and evening (18:00–20:00) hours.
Results. The findings showed interrelationship between natriuresis and urine conductivity: correlation coefficients between natriuresis and urine conductivity in the morning, daytime and evening urine samples were r=0.987, p<0.0001, r=0.982, p<0.0001 and r=0.989, p<0.0001, respectively. Patients with «night-peaker» AD profile were found to have a sharp rise in the level of natriuresis and urine conductivity («peak»). Examining the likelihood of adverse circadian blood pressure profile depending on the «peak» of sodium excretion and urine conductivity showed that evening «peak» of natriuresis and urine conductivity increases the possibility of 24-hour «night-peaker» (to a greater extent) and «non-dipper» AD profiles.
Conclusion. Natriuresis, which reflects the functional state of renal TIT and its circadian disturbances, is able to most fully reveal the risk of adverse blood pressure profile. Screening of natriuresis by measuring urine conductivity in the evening hours allows adverse blood pressure profiles to be predicted with high
probability.
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