The relationship between cognitive function, depressive behaviour and sleep quality with 24-h urinary sodium excretion in patients with essential hypertension

High Blood Press Cardiovasc Prev. 2013 Mar;20(1):19-24. doi: 10.1007/s40292-013-0002-7. Epub 2013 Mar 26.

Abstract

Background: Various studies have shown that sodium intake is related to increased blood pressure. However, the relationship between sodium intake and cognitive function and depression has not previously been studied.

Aim: The objective of this study was to investigate the relationship between 24-h sodium excretion with cognitive function, depression and sleep quality in patients newly diagnosed with essential hypertension.

Methods: All patients underwent history taking, physical examination, blood pressure measurement, 12-lead ECG evaluation, routine urine analysis, biochemical analysis and 24-h urine collection to measure urinary sodium and protein excretion and creatinine clearance, evaluation of cognitive function, depressive behaviour and sleep quality.

Results: In total, 119 patients newly diagnosed with essential hypertension (50 men and 69 women aged 54.2 ± 16.1 years) were enrolled. The 24-h urinary sodium excretion of the patients was 204.0 ± 240.4 mEq/day. The Standardized Mini Mental State Examination (SMMSE), Pittsburgh Sleep Quality Index and Beck Depression Inventory scores of the patients were 26.0 ± 2.7, 5.6 ± 3.1 and 21.6 ± 13.5, respectively. Spearman correlation analysis revealed that 24-h urinary sodium excretion was correlated with age (rho -0.258, p = 0.005), systolic blood pressure (rho 0.219, p = 0.017), diastolic blood pressure (rho 0.195, p = 0.034), creatinine clearance (rho 0.414, p < 0.0001) and SMMSE score (rho -0.257, p = 0.005). Stepwise linear regression of independent factors revealed that gender (p < 0.0001), creatinine clearance (p < 0.0001), systolic blood pressure (p = 0.031) and SMMSE score (p < 0.0001) were independently related to logarithmically converted 24-h sodium excretion.

Conclusion: The current study demonstrated that better cognitive function, but not depressive behaviour and sleep disturbance, is related to decreased sodium intake as evaluated by 24-h urinary sodium excretion. Studies are needed to highlight the mechanisms regarding the relationship between cognitive function and sodium intake.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / urine
  • Blood Pressure*
  • Cognition*
  • Creatinine / urine
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / etiology*
  • Depression / psychology
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / psychology
  • Hypertension / urine
  • Linear Models
  • Male
  • Middle Aged
  • Natriuresis*
  • Risk Factors
  • Sex Factors
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / etiology*
  • Sleep Wake Disorders / physiopathology
  • Sleep Wake Disorders / psychology
  • Sleep*
  • Sodium Chloride, Dietary / adverse effects
  • Sodium Chloride, Dietary / urine
  • Time Factors

Substances

  • Biomarkers
  • Sodium Chloride, Dietary
  • Creatinine