PotassiumNEW2026-10

Psychological Stress and the Diurnal Patterns of Sodium Excretion and Blood Pressure: Results From the SABRE Study.

Fang Chloe, Barrett Matthew, Cepeda Maria, Choi Eunhee et al. — Journal of the American Heart Association

Summary

This study explored how psychological stress might affect blood pressure by influencing the body's handling of sodium. Researchers found that individuals who had a weaker sodium response to stress also showed less healthy daily patterns of sodium excretion, which was then linked to a smaller, less beneficial drop in blood pressure during sleep.

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Key points

Psychological stress can influence how the body excretes sodium.
A weaker sodium response to stress is linked to less healthy daily sodium excretion patterns.
Disrupted daily sodium excretion patterns are associated with a smaller, less beneficial drop in blood pressure during sleep.

What the study looked at

This study investigated the connection between psychological stress, how our bodies handle sodium, and the natural daily changes in blood pressure, especially the important drop in blood pressure that typically occurs during sleep. To explore this, apparently healthy adults participated in a lab session where their urine was collected before and after performing mental stress tasks to measure how stress affected their sodium excretion. They also wore blood pressure monitors for 24 hours and collected urine samples throughout the day and night to track their daily blood pressure rhythms and sodium excretion patterns. The findings showed that individuals who excreted less sodium in response to stress also exhibited a less healthy daily pattern of sodium excretion, meaning less difference between their awake and asleep sodium levels. This less healthy daily sodium excretion pattern was then linked to a smaller drop in systolic blood pressure during sleep, which is generally considered less favorable for cardiovascular health.

Dietary takeaway

While this study focused on sodium, maintaining a balanced diet rich in potassium-rich foods like fruits, vegetables, and legumes can help support overall cardiovascular health and may indirectly help the body manage sodium levels, especially during times of stress. This balance is crucial for healthy blood pressure. Remember, this is just one study, and more research is needed to fully understand the complex interplay between stress, sodium, potassium, and blood pressure.

Abstract

BACKGROUND: Psychological stress is associated with reduced blood pressure (BP) dipping, but the underlying mechanisms are unclear. This study examined the associations among stress-induced sodium excretion, diurnal sodium excretion, and BP dipping. METHODS: Apparently healthy adult participants underwent a laboratory session during which urinary sodium excretion was measured before and after mental stress tasks. Participants then completed 24-hour ambulatory BP monitoring and separate awake and asleep urine collections. The change in urinary sodium excretion rate with stress was defined as the difference in urinary sodium excretion rate before and after stress. The awake-to-asleep ratio of the urinary sodium excretion rate and systolic BP dipping were calculated from the 24-hour urine and BP measurements. RESULTS: In an adjusted model including age, sex, race, ethnicity, body mass index, mean systolic BP, mean diastolic BP, parental history of hypertension, fasting glucose, and 24-hour creatinine clearance, a smaller stress-induced urinary sodium excretion rate was associated with a lower awake-to-asleep ratio of urinary sodium excretion rate (n=180, B=0.2253 [95% CI, 0.0490-0.4016]). In an adjusted model including age, sex, race, ethnicity, body mass index, current smoking, alcohol use, fasting glucose, 24-hour sodium excretion, 24-hour potassium excretion, 24-hour creatinine clearance, and fractional excretion of sodium, a lower awake-to-asleep ratio of the urinary sodium excretion rate was associated with lower systolic BP dipping (n=175, B=1.0127 [95% CI, 0.0599-1.9656]). CONCLUSIONS: A lower stress-induced urinary sodium excretion rate was associated with a worse diurnal pattern of urinary sodium excretion, which was associated with lower systolic BP dipping. REGISTRATION INFORMATION: clinicaltrials.gov. Identifier: NCT03636490.

View on PubMed →DOI: 10.1161/JAHA.126.050471