Association of sodium and potassium intake with ventricular arrhythmic burden in patients with essential hypertension

• Published in: Journal of the American Society of Hypertension Vol. 7; no. 4; pp. 276 - 282
• Main Authors: Marketou, Maria E., MD, PhD, Zacharis, Evangelos A., MD, PhD, Parthenakis, Fragiskos, MD, PhD, Kochiadakis, George E., MD, PhD, Maragkoudakis, Spyros, MD, Chlouverakis, Gregory, PhD, Vardas, Panos E., MD, PhD, FESC, FACC
• Format: Journal Article
• Language: English
• Published: United States 01.07.2013
• Subjects: Aged; Blood Pressure - physiology; Cardiovascular; Diet, Sodium-Restricted; Electrocardiography, Ambulatory; Female; Humans; Hypertension - diet therapy; Hypertension - metabolism; Male; Middle Aged; Potassium, Dietary - urine; Severity of Illness Index; Sodium, Dietary - urine; Ventricular Premature Complexes - diagnosis; Ventricular Premature Complexes - diet therapy; Ventricular Premature Complexes - metabolism; urinary sodium; Essential hypertension; urinary potassium; ventricular arrhythmias
• ISSN: 1933-1711; 1878-7436
• DOI: 10.1016/j.jash.2013.04.002

Abstract Background Hypertensive populations suffer from an increased susceptibility to ventricular arrhythmias and sudden cardiac death. A high-salt diet appears to be a major factor involved in cardiovascular complications in hypertension. We examined the relationship between dietary salt and potassium, as indicated by urinary sodium (UNa), urinary potassium (UK), and urinary sodium/potassium ratio (UNa/K), and the arrhythmic burden in patients with essential hypertension. Methods We included 255 consecutive adult patients with well-controlled hypertension who were being followed in the hypertension outpatient clinic of a university tertiary hospital and complained of episodes of atypical chest pain and/or palpitations. All underwent 24-hour ambulatory electrocardiograph monitoring and their UNa, UK, and UNa/K ratio from 24-hour urinary excretion specimens were evaluated. Results No significant correlation was found between premature supraventricular contractions and the parameters that were examined. However, the percentage of premature ventricular contractions (PVC%) showed a weak positive association with UNa (r = 0.2; P = .001) and a moderate negative association with UK (r = −0.396; P < .001). The partial correlation coefficient of PVC% with the UNa/UK ratio remained significant even after controlling for left ventricular mass index (r = 0.437; P < .001). Conclusions A higher UNa/UK excretion ratio is significantly associated with PVCs, indicating an increased susceptibility to ventricular arrhythmias even among hypertensives with well-controlled blood pressure. Our findings reinforce recommendations for dietary interventions in those populations.