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Sodium-lithium countertransport and blood pressure change over time: the Gubbio study
M Cirillo1, M Laurenzi, W Panarelli
1Division of Nephrology, Medical School, Second Naples University, Italy.
Insights
Sodium-lithium countertransport in red blood cells predicts blood pressure changes over time in adults. Higher activity is linked to significant blood pressure increases, particularly in older individuals or those with elevated baseline pressure.
Area of Science:
- Cardiovascular Physiology
- Hypertension Research
- Biomarker Discovery
Background:
- Sodium-lithium (Na-Li) countertransport activity in red blood cells is associated with blood pressure (BP) and hypertension prevalence.
- Understanding the longitudinal relationship between Na-Li countertransport and BP changes is crucial for hypertension management.
Purpose of the Study:
- To investigate the association between baseline Na-Li countertransport activity and subsequent BP change over a 6-year follow-up period in an adult population.
- To identify specific subgroups where this association is most pronounced.
Main Methods:
- Longitudinal observational study (Gubbio Population Study) with 2729 adult participants.
- Baseline measurements included Na-Li countertransport, BP, demographics, and clinical data.
- BP change was assessed over a 6-year follow-up period, with statistical analyses controlling for confounders.
Main Results:
- Baseline Na-Li countertransport activity showed a significant, direct relationship with BP change over 6 years.
- This association was particularly strong in individuals with baseline BP ≥ 120/80 mm Hg or aged ≥ 45 years.
- Multiple regression analyses confirmed Na-Li countertransport as a significant predictor of BP change, especially when analyzed categorically.
Conclusions:
- Red blood cell Na-Li countertransport is a significant predictor of longitudinal BP changes in adults.
- Na-Li countertransport may serve as a valuable biomarker for identifying individuals at risk of developing or worsening hypertension.
- The predictive value is enhanced in older adults and those with pre-existing elevated BP.
Abstract:
Sodium-lithium countertransport activity in red blood cells relates to blood pressure (BP) and the prevalence of hypertension. This study investigated in adults the relation of sodium-lithium (Na-Li) countertransport to BP change from baseline to 6-year follow-up. In the Gubbio Population Study, 4210 men and women were 18 to 74 years old at baseline (1983-1986), and 3766 had a valid baseline Na-Li countertransport measurement; of these, 2729 were reexamined at 6 years of follow-up (1989-1992) and made up the study cohort. At baseline, data collection included age, height, weight, BP, pulse rate, drug treatment, alcohol intake, ratio of sodium to potassium in spot urine, plasma cholesterol, and Na-Li countertransport in red blood cells. At 6-year follow-up, data for age, BP, and drug treatment were collected as at baseline. From baseline, average BP declined for people on antihypertensive medication at follow-up and for those with baseline BP greater than or equal to 140/90 mm Hg (systolic/diastolic) and did not change or increased for the remaining participants. In quartile and correlation analyses controlled for sex, baseline BP, and antihypertensive treatment, BP change related significantly and directly to baseline Na-Li countertransport. In multiple linear regression analyses done for the entire cohort with control for other confounders, the regression coefficient of baseline Na-Li countertransport to BP change over time was positive and borderline significant. The Na-Li countertransport coefficient was positive and significant when analyses were done with the use of a categorical value of baseline Na-Li countertransport (quartile 4 and quartiles 1 through 3 combined). In both models, the Na-Li countertransport coefficient was the strongest for people with baseline BP greater than or equal to 120/80 mm Hg or for people with baseline age of 45 years or older. In conclusion, Na-Li countertransport significantly relates to BP change over time in adults.