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From the Department of Clinical and Experimental Medicine (P.S., E.R.,
L.R., R.I.) and Community Medicine–Department of Hygiene (E.F.),
"Federico II" University of Naples Medical School, Naples; the
Epidemiology and Prevention Unit, Institute of Food Sciences and Technology,
National Research Council, Avellino (A.S.), Italy; the Blood Pressure Unit,
Department of Medicine, St George's Hospital Medical School, London, UK
(F.P.C.); and the Department of Social and Preventive Medicine, State
University of New York at Buffalo (M.T.).
Correspondence to P. Strazzullo, MD, Department of Clinical and Experimental Medicine, "Federico II" University of Naples, via S. Pansini 5, 80131 Naples, Italy. E-mail strazzul{at}unina.it
Abstract—An elevated red blood cell
(RBC) sodium-lithium countertransport (Na-Li CT) is associated with
high blood pressure (BP) in cross-sectional investigations; however,
its value as a predictor of future hypertension, and thus of
cardiovascular risk, has not been defined. The
present study evaluated the association between Na-Li CT and risk
of future hypertension in a sample of 106 untreated normotensive
middle-aged men participating in the Olivetti Prospective Heart Study
in southern Italy. BP, anthropometric and metabolic
variables, and RBC Na-Li CT were measured at baseline in 1987 and
at a follow-up visit in 1994 through 1995. Na-Li CT was stable over
time (r=0.85) and was significantly associated to
systolic BP in both visits. Of the 106 initially normotensive
participants, 14 were found to be hypertensive at the 8-year follow-up
examination. Eleven of these 14 hypertensives were in the highest
tertile of systolic BP at baseline, and 9 of 11 also had an
elevated baseline Na-Li CT. In multiple logistic regression
analysis, baseline BP, Na-Li CT, and age were all significant
predictors of the risk of future hypertension. Individuals with
baseline systolic BP in the highest tertile had a 60% risk of
developing hypertension if their Na-Li CT was also high, whereas their
risk was only 5% if Na-Li CT was in the two lowest tertiles
(P=0.003). RBC Na-Li CT was a valuable predictor of
subsequent hypertension in middle-aged men with a high-normal BP level
for their age.
© 1998 American Heart Association, Inc.
Scientific Contributions
Red Blood Cell Sodium-Lithium Countertransport and Risk of Future Hypertension
The Olivetti Prospective Heart Study
Key Words: hypertension, essential • blood pressure • risk factors • ion transport • genetics • erythrocytes
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