Psychological Stress and the Diurnal Patterns of Sodium Excretion and Blood Pressure: Results From the SABRE Study
5 affiliations
- 1Columbia University Irving Medical Center
- 2Beth Israel Deaconess Medical Center, Harvard Medical School, Department of Medicine, Division of General Medicine
- 3Stony Brook University
- 4Columbia University
- 5University of Alabama at Birmingham
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.
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BibTeX
@article{fang2026psychological,
title = {{Psychological Stress and the Diurnal Patterns of Sodium Excretion and Blood Pressure: Results From the SABRE Study}},
author = {Chloe Fang and Matthew Barrett and Maria Cepeda and Eunhee Choi and Melissa Dong and Brulinda Frangaj and Stephen P. Juraschek and Ariana LaRocca and Matthew T. McGoldrick and Yaniris Mercado and Patrick Pham and Joseph E. Schwartz and Heather Seid and S. Justin Thomas and Daichi Shimbo},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.126.050471},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.050471},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Psychological Stress and the Diurnal Patterns of Sodium Excretion and Blood Pressure: Results From the SABRE Study
AU - Chloe Fang
AU - Matthew Barrett
AU - Maria Cepeda
AU - Eunhee Choi
AU - Melissa Dong
AU - Brulinda Frangaj
AU - Stephen P. Juraschek
AU - Ariana LaRocca
AU - Matthew T. McGoldrick
AU - Yaniris Mercado
AU - Patrick Pham
AU - Joseph E. Schwartz
AU - Heather Seid
AU - S. Justin Thomas
AU - Daichi Shimbo
PY - 2026
DA - 2026/10/20
JO - Journal of the American Heart Association
DO - 10.1161/jaha.126.050471
UR - https://www.ahajournals.org/doi/10.1161/JAHA.126.050471
AB - 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.
SN - 2047-9980
ER -