Hypertension, Vol 10, 417-424, Copyright © 1987 by American Heart Association
AR Dyer, R Stamler, R Grimm, J Stamler, R Berman, FC Gosch, LA Emidy, P Elmer, J Fishman and N Van Heel
Studies generally indicate that excretion of sodium, potassium, and water
is greater during the day than during the night. To determine whether
hypertensive patients exhibit this same pattern of excretion, diurnal
variations in excretion of sodium, potassium, creatinine, and water were
examined in 107 hypertensive men and women from a clinical trial on control
of hypertension by nonpharmacological means--the Hypertension Control
Program. Each participant provided two carefully timed 24-hour urine
collections divided into daytime and overnight specimens. The median ratios
of 24-hour to 8-hour overnight excretion were 2.84, 3.95, 2.99, and 2.77
for sodium, potassium, creatinine, and water, respectively. Thus, more than
half of this hypertensive group exhibited a greater rate of sodium and
water excretion during sleep than during daytime hours, a reversal of the
usual pattern. When the group was subdivided based on age, sex, race, trial
randomization group, use of diuretics, and hypertension severity, women had
significantly lower ratios of 24-hour to overnight excretion for sodium and
water than men and blacks had significantly lower 24-hour to overnight
ratios for water and potassium than whites. When the 24-hour to overnight
ratios for these hypertensive patients were compared with those for a group
of 30 men and women with high-normal blood pressure, those with high-normal
blood pressure had significantly larger ratios for sodium and water
excretion than the hypertensive group. The results of this study suggest
that hypertensive patients may have a different diurnal pattern of sodium
and water excretion than normotensive subjects and that further research is
needed to clarify this issue.
ARTICLES
Do hypertensive patients have a different diurnal pattern of electrolyte excretion?
Department of Community Health and Preventive Medicine, Northwestern University Medical School, Chicago, Illinois.
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