Potassium excretion and blood pressure are associated with heart rate variability in healthy black adults: The African-PREDICT study.


Journal

Nutrition, metabolism, and cardiovascular diseases : NMCD
ISSN: 1590-3729
Titre abrégé: Nutr Metab Cardiovasc Dis
Pays: Netherlands
ID NLM: 9111474

Informations de publication

Date de publication:
09 04 2021
Historique:
received: 28 10 2020
revised: 09 12 2020
accepted: 11 12 2020
pubmed: 8 2 2021
medline: 7 4 2021
entrez: 7 2 2021
Statut: ppublish

Résumé

Heart rate variability (HRV) is a main determinant of autonomic function and related to the development of hypertension and cardiovascular (CV) disease. Hypertension develops in black populations at an earlier age, which could be due to differences in the autonomic nervous system activity and sodium/potassium handling in black and white populations. We investigated whether HRV is associated with 24 h urinary sodium and potassium excretion and blood pressure (BP) in a young bi-ethnic cohort. We examined 423 black and 483 white healthy adults (aged 24.5 ± 3.1 years) for 24 h HRV, including standard deviation of normal RR intervals (SDNN) reflecting autonomic variations over time, and root mean square of successive differences (RMSSD) reflecting parasympathetic activity. We measured 24 h urinary sodium and potassium concentration and BP. The black group had lower SDNN and potassium excretion as well as higher RMSSD, sodium and Na/k ratio compared to the white group (all p < 0.05). Only in black individuals, urinary potassium excretion was independently and negatively associated with SDNN (β[95% CI];-0.26[-0.50;-0.02]ms) and RMSSD (-0.14[-0.27;-0.01]ms, p < 0.05). One unit increase in sodium/potassium (Na/K) ratio was associated with higher SDNN (β[95% CI]; 3.04[0.89; 5.19]ms) and RMSSD (1.60[0.41; 2.78]ms) in the black cohort only (both p < 0.001). In both groups elevated 24 h diastolic BP was associated with lower RMSSD (p < 0.05). Lower potassium excretion and higher Na/K ratio related independently to higher HRV in young and healthy black adults. A better ethnic-specific understanding of sodium and potassium handling is required as part of preventive cardiology, especially in black individuals. ClinicalTrials.gov Identifier: NCT03292094; URL: https://clinicaltrials.gov/ct2/show/NCT03292094.

Sections du résumé

BACKGROUND AND AIMS
Heart rate variability (HRV) is a main determinant of autonomic function and related to the development of hypertension and cardiovascular (CV) disease. Hypertension develops in black populations at an earlier age, which could be due to differences in the autonomic nervous system activity and sodium/potassium handling in black and white populations. We investigated whether HRV is associated with 24 h urinary sodium and potassium excretion and blood pressure (BP) in a young bi-ethnic cohort.
METHODS AND RESULTS
We examined 423 black and 483 white healthy adults (aged 24.5 ± 3.1 years) for 24 h HRV, including standard deviation of normal RR intervals (SDNN) reflecting autonomic variations over time, and root mean square of successive differences (RMSSD) reflecting parasympathetic activity. We measured 24 h urinary sodium and potassium concentration and BP. The black group had lower SDNN and potassium excretion as well as higher RMSSD, sodium and Na/k ratio compared to the white group (all p < 0.05). Only in black individuals, urinary potassium excretion was independently and negatively associated with SDNN (β[95% CI];-0.26[-0.50;-0.02]ms) and RMSSD (-0.14[-0.27;-0.01]ms, p < 0.05). One unit increase in sodium/potassium (Na/K) ratio was associated with higher SDNN (β[95% CI]; 3.04[0.89; 5.19]ms) and RMSSD (1.60[0.41; 2.78]ms) in the black cohort only (both p < 0.001). In both groups elevated 24 h diastolic BP was associated with lower RMSSD (p < 0.05).
CONCLUSION
Lower potassium excretion and higher Na/K ratio related independently to higher HRV in young and healthy black adults. A better ethnic-specific understanding of sodium and potassium handling is required as part of preventive cardiology, especially in black individuals.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03292094; URL: https://clinicaltrials.gov/ct2/show/NCT03292094.

Identifiants

pubmed: 33549447
pii: S0939-4753(20)30547-0
doi: 10.1016/j.numecd.2020.12.021
pii:
doi:

Substances chimiques

Sodium 9NEZ333N27
Potassium RWP5GA015D

Banques de données

ClinicalTrials.gov
['NCT03292094']

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1071-1080

Subventions

Organisme : Medical Research Council
ID : MC_PC_16095
Pays : United Kingdom

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The Author(s) declare(s) that there is no conflict of interest.

Auteurs

Sabrina Köchli (S)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.

Aletta E Schutte (AE)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa; School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, Australia.

Shani Botha-Le Roux (S)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

Lebo F Gafane-Matemane (LF)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

Wayne Smith (W)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

Johannes M van Rooyen (JM)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

Gontse G Mokwatsi (GG)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.

Ruan Kruger (R)

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa. Electronic address: Ruan.kruger@g.nwu.ac.za.

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