Dong Melissa, McGoldrick Matthew T, Seid Heather, Cohen Laura P, LaRocca Ariana, Pham Patrick, Thomas S Justin, Schwartz Joseph E, Shimbo Daichi
Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY 10032, United States of America.
Bionutrition Research Core, Irving Institute of Clinical and Translational Research, Columbia University, 622 West 168th Street, New York, NY 10032, United States of America.
Am Heart J Plus. 2022 Jan 31;13:100099. doi: 10.1016/j.ahjo.2022.100099. eCollection 2022 Jan.
Abnormal diurnal patterns of blood pressure (BP) on ambulatory BP monitoring (ABPM), defined by reduced BP dipping or elevated nighttime BP, are associated with increased risk for adverse cardiovascular events. Psychological stress is associated with abnormal diurnal patterns of BP. Exposure to an acute stressor (e.g., mental stress task) normally increases urinary sodium excretion. However, some individuals have sodium retention after stress provocation, revealing substantial between-person variability in the degree of stress-induced sodium excretion. Prior research suggests urinary sodium excretion that does not occur during the daytime may shift toward the nighttime, accompanied by an increase in nighttime BP. Associations between psychological stress and the diurnal patterns of sodium excretion and BP are not yet fully understood.
The study is conducted in both the laboratory and naturalistic environment with a multi-racial/ethnic sample of 211 healthy adults. In the laboratory, change in urinary sodium excretion in response to mental stress tasks is examined with pre-/post-stress assessments of sodium excretion. Changes in angiotensin-II, catecholamines, BP, heart rate, endothelin-1, and cortisol are also assessed. In the 24-hour naturalistic environment, the diurnal patterns of sodium excretion and systolic BP are assessed as daytime-to-nighttime ratio of sodium excretion and ABPM, respectively. Ecological momentary assessments of perceived stress are also collected.
The SABRE study investigates previously unexplored associations between stress-induced urinary excretion in the laboratory, diurnal patterns of sodium excretion and BP in the naturalistic environment, and ecological stress. It has high potential to advance our understanding of the role of psychological stress in hypertension.
动态血压监测（ABPM）中血压（BP）的异常昼夜模式，表现为血压下降减弱或夜间血压升高，与心血管不良事件风险增加相关。心理压力与血压的异常昼夜模式有关。暴露于急性应激源（如心理应激任务）通常会增加尿钠排泄。然而，一些个体在应激刺激后会出现钠潴留，这表明应激诱导的钠排泄程度存在显著的个体差异。先前的研究表明，白天未发生的尿钠排泄可能会转向夜间，同时夜间血压会升高。心理压力与钠排泄和血压的昼夜模式之间的关联尚未完全了解。
该研究在实验室和自然环境中对211名健康成年人的多种族/民族样本进行。在实验室中，通过应激前后的钠排泄评估来检查对心理应激任务的尿钠排泄变化。还评估了血管紧张素-II、儿茶酚胺、血压、心率、内皮素-1和皮质醇的变化。在24小时自然环境中，分别将钠排泄和收缩压的昼夜模式评估为钠排泄的白天与夜间比值和ABPM。还收集了感知压力的生态瞬时评估。
SABRE研究调查了实验室中应激诱导的尿排泄、自然环境中钠排泄和血压的昼夜模式以及生态应激之间以前未探索的关联。它极有可能推进我们对心理压力在高血压中作用的理解。
