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Associations between Arterial Stiffness, Electrolytes, and Hormones: Insights from the LURIC Study on Cardiovascular
Angela P Moissl-Blanke1,2, Graciela E Delgado2, Goekhan Yücelq1
1Department of Medicine I (Cardiology, Angiology, Hemostaseology, Intensive Care), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Insights
Elevated pulse pressure (PP) is linked to cardiovascular events. This study found specific electrolyte imbalances associated with higher PP and arterial stiffness, highlighting sex-specific risks and potential interventions.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Endocrinology
Background:
- Pulse pressure (PP), the difference between systolic and diastolic blood pressure, is a key indicator of cardiovascular health and arterial stiffness.
- Elevated PP correlates with increased risk of cardiovascular events, a leading cause of mortality.
- This research investigates the relationship between PP and crucial electrolytes (sodium, potassium, calcium, magnesium, phosphate, vitamin D).
Purpose of the Study:
- To examine the association between pulse pressure and key electrolyte levels.
- To explore the role of these electrolytes in blood pressure regulation and vascular function.
- To identify potential links between electrolyte imbalances and cardiovascular risk factors.
Main Methods:
- Analysis of data from 3,316 participants in the LURIC study with a median follow-up of 9.9 years.
- Assessment of associations between PP and electrolyte levels using Spearman correlation.
- Logistic regression models to calculate odds ratios for mortality, reduced eGFR, and type 2 diabetes mellitus.
Main Results:
- Higher PP was associated with older age, higher BMI, and increased prevalence of coronary artery disease and peripheral arterial disease.
- Potassium, phosphate, and vitamin D levels decreased with increasing PP, while sodium remained unchanged.
- The sodium-potassium ratio and aldosterone-renin ratio increased with higher PP, with sex-specific risks for cardiovascular mortality and reduced eGFR.
Conclusions:
- Electrolyte imbalances are significantly linked to increased pulse pressure and arterial stiffness.
- Findings indicate sex-specific cardiovascular risks associated with pulse pressure.
- Further research into nutrient-based and hormonal interventions for pulse pressure modulation is supported.
Background:
Pulse pressure (PP), the difference between systolic (SBP) and diastolic blood pressure (DBP), is an essential marker of cardiovascular (CV) health and arterial stiffness. Elevated PP is linked to a higher risk of CV events, a major cause of global mortality. This study examines its association with key electrolytes - sodium, potassium, calcium, magnesium, phosphate, and vitamin D - in blood-pressure regulation and vascular function.
Methods:
We analysed data from 3,316 LURIC participants who underwent coronary angiography and had a median follow-up of 9.9 years. Fasting blood samples were collected at baseline. Associations between PP and electrolyte levels were assessed using Spearman correlation. Logistic regression models were used to calculate odds ratios (ORs) per standard deviation (SD) of PP and electrolyte concentrations for four clinical outcomes: all-cause mortality, CV mortality, reduced estimate the glomerular filtration rate (eGFR), and type 2 diabetes mellitus.
Results:
The cohort's average age was 62.7 years, with 70% of participants being male. Higher PP was significantly associated with older age, increased body mass index, and the prevalence of coronary artery disease (CAD), carotid stenosis, and peripheral arterial disease. Potassium, phosphate, renin, 25-OH, and 1,25-OH vitamin D concentrations decreased significantly as PP increased, while sodium remained unchanged. Sodium-potassium ratio and aldosterone-renin ratio increased with higher PP. Women had a higher risk of CV mortality per SD of PP (OR 1.57; 95% confidence interval [CI]: 1.33-1.86), while men showed a greater risk of reduced eGFR (OR 1.59; 95% CI: 1.40-1.80).
Conclusion:
Specific electrolyte imbalances are closely linked to increased PP and arterial stiffness. Our findings highlight sex-specific CV risk and support further research into nutrient-based and hormonal interventions targeting PP modulation.
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