Abstract 62: Gender Differences in Salt Sensitivity Approximated from Ambulatory Blood Pressure Monitoring and Mortality
We analyzed 2168 ambulatory BP monitoring (ABPM) tracings of untreated patients from our clinical service database for the prevalence, associations and outcome of salt sensitivity (SS), as approximated from monitoring indices. SS was considered low (SSL) in patients with both mean arterial pressure (MAP) dipping >10% and 24h heart rate (HR) <70 bpm; high (SSH) in patients with MAP dipping ≤10% and 24h HR ≥70 bpm; and intermediate (SSI) in patients with other combinations of MAP dipping and 24h HR. Associations with demographic and monitoring variables were evaluated by ANOVA, multivariate general linear models and survival analyses. SSH was predicted for 11% (123/1116) of men and 16% (168/1012) of women (χ2 P<0.0001). Diabetes was more common among SSH men 6.5% (8/123) vs. 3.8% (6/168) in women, P=0.004. Positive linear trends (all P<0.05) were noted between SS and body mass index, clinic BP, 24h ambulatory BP, awake and sleep ambulatory HR and awake and sleep ambulatory BP variability. A negative trend existed with HR dipping (P<0.05). Adjustment for multiple variables abolished the linear associations of SS with clinic BP, ambulatory BP variability and HR dipping. Kaplan-Meier analyses revealed increased mortality in association with SS in men but not in women (Figure). With pooled SSL/SSI as reference, adjusted Cox proportional hazards ratios for all-cause mortality were 1.85 (95%CI 1.03-3.35) among SSH men and 1.03 (0.50-2.13) in women. In conclusion, to the extent that ABPM-derived estimation of SS is feasible, analysis of our ABPM database suggests increased mortality in SS men but not in women in whom SS was more common.
- © 2012 by American Heart Association, Inc.