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(Hypertension. 1999;33:887-893.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Prospective Analysis of Traits Related to 6-Year Change in Sodium-Lithium Countertransport

Massimo Cirillo; Martino Laurenzi; Walter Panarelli; Maurizio Trevisan; Jeremiah Stamler; for the Gubbio Population Study Research Group

From the Division of Nephrology (M.C.), Second Medical School, Naples (Italy) University; Department of Preventive Medicine (M.C., M.L., J.S.), Northwestern University Medical School, Chicago, Ill; Center for Epidemiologic Research (M.L.), Merck Sharp & Dohme–Italy, Rome; Gubbio (Italy) Civil Hospital (W.P.); and Department of Social and Preventive Medicine (M.T.), State University of New York at Buffalo.

Correspondence to Jeremiah Stamler, MD, Department of Preventive Medicine, Northwestern University Medical School, 680 N Lake Shore Dr, Suite 1102, Chicago, IL 60611. E-mail hwe216{at}lulu.acns.nwu.edu

Abstract—Sodium-lithium countertransport (Na-Li CT) activity in red blood cells relates cross-sectionally and longitudinally to blood pressure and hypertension. Lifestyle and metabolic factors relate cross-sectionally to this sodium transporter. The aim of this study was to conduct a prospective analysis of 6-year Na-Li CT change and of traits related to Na-Li CT change. In 2183 participants in the Gubbio Population Study (972 men and 1211 women; baseline ages, 18 to 74 years), the following data collected at baseline and 6-year follow-up were analyzed: Na-Li CT; gender; age; body mass index (BMI); blood pressure; antihypertensive treatment; alcohol intake; smoking habits; urinary sodium-to-potassium ratio; and plasma cholesterol, glucose, uric acid, sodium, potassium, and triglycerides (measured only at follow-up). Six-year changes were defined as follow-up minus baseline values. Na-Li CT was higher at follow-up than at baseline in both genders (P<0.001). Baseline Na-Li CT; baseline and change values of BMI; and change values of alcohol intake, plasma potassium, and plasma glucose related to Na-Li CT change significantly and independently with control for other variables. Follow-up plasma triglyceride levels also related independently to Na-Li CT change. Coefficients were positive for BMI, alcohol intake, and plasma glucose and triglyceride levels and were negative for baseline Na-Li CT and plasma potassium levels. Baseline and change values of other variables did not relate significantly to Na-Li CT change. In conclusion, in prospective analyses, BMI, alcohol intake, plasma glucose, and lipids were directly related to Na-Li CT change; baseline Na-Li CT and plasma potassium levels were inversely related. The data support the concept that lifestyle and related metabolic factors influence Na-Li CT.

Key Words: sodium-lithium countertransport • body mass index • alcohol • plasma glucose • plasma lipids • plasma potassium • Gubbio Population Study