High sodium intake is associated with masked hypertension in Japanese patients with type 2 diabetes and treated hypertension.
BACKGROUND
Knowledge regarding the association between dietary sodium intake and the incidence of masked hypertension is limited.


METHODS
A total of 193 Japanese type 2 diabetic outpatients who had been treated with antihypertensive agents and with office blood pressures <140/90 mm Hg were recruited. Masked hypertension was defined as having office blood pressure <140/90 mm Hg and 24-h mean ambulatory blood pressure ≥130/80 mm Hg. The dietary sodium intake was estimated by measuring the 24-h urinary sodium excretion.


RESULTS
Masked hypertension was found in 128 (66.3%) patients. An age- and sex-adjusted univariate logistic regression analysis showed that urinary albumin excretion, renin-angiotensin system inhibitor use, office systolic blood pressure, and amount of dietary sodium intake were significantly associated with masked hypertension. A multivariate logistic regression analysis also identified an older age, renin-angiotensin system inhibitor use, an office elevated systolic blood pressure, and high dietary sodium intake to be independently associated with masked hypertension. When compared with those who consumed a low salt diet (sodium <120 mEq/day), the odds ratio for the risk of exhibiting masked hypertension in patients who consumed a medium salt diet (sodium 120 to <200 mEq/day) or a high salt diet (sodium ≥200 mEq/day) were 5.3 (P < 0.001) and 12.6 (P < 0.001), respectively.


CONCLUSIONS
Masked hypertension is a common feature in type 2 diabetic patients being treated for hypertension. The observed association with sodium intake raised the hypothesis that excessive sodium intake may play a part in the genesis of masked hypertension in these patients.
Department of Medicine, Shiga University of Medical Science, Shiga, Japan. takuzu@belle.shiga-med.ac.jp
Takashi
T
Uzu
Keiko
K
Nakao
Shinji
S
Kume
Hisazumi
H
Araki
Keiji
K
Isshiki
Shin-Ichi
S
Araki
Hiromichi
H
Kawai
Satoshi
S
Ugi
Atsunori
A
Kashiwagi
Hiroshi
H
Maegawa
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044466:Asian People; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004039:Diet, Sodium-Restricted; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D059468:Masked Hypertension / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D012084:Renin-Angiotensin System / Q000187:drug effects; D012964:Sodium / Q000652:urine; D012982:Sodium, Dietary / Q000008:administration & dosage*
D000959:Antihypertensive Agents; D012982:Sodium, Dietary; D012964:Sodium