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Sex influences blood pressure but not blood pressure variability in response to dietary sodium and potassium in salt-resistant adults

Journal of Human Hypertension volume 38, pages 62–69 (2024)Cite this article

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Abstract

Dietary sodium and potassium have been shown to affect blood pressure (BP) but their influence on BP variability (BPV) is less studied as is the influence of sex. The aim of this study was to compare 24 h BP and short-term BPV in response to varying dietary levels of sodium and potassium in healthy non-obese normotensive salt-resistant adults. We hypothesized that high sodium would increase short-term BP and BPV while the addition of high potassium would counteract this increase. Furthermore, we hypothesized that women would experience greater increases in BPV under high sodium conditions compared to men while potassium would attenuate this response. Thirty-seven participants (17 M/20 W; 27 ± 5 years old; BMI 24.3 ± 3 kg/m2) completed seven days each of the following randomized diets: moderate potassium/low sodium (MK/LS), moderate potassium/high sodium (MK/HS) and high potassium/high sodium (HK/HS). BP and short-term BPV were assessed using 24 h ambulatory BP monitoring starting on day 6. BPV was calculated using the average real variability (ARV) index. Twenty-four hour, daytime, and nighttime systolic BP (SBP) were lower in women compared to men regardless of diet. However, 24 h and daytime SBP were lowered in women on the HK/HS diet compared to the MK/HS diet. There were no significant effects of diet or sex for 24 h, daytime or nighttime SBP ARV. However, men exhibited a higher 24 hDBP ARV than women regardless of diet. In conclusion, a high potassium diet lowered BP under high sodium conditions in women alone while men exhibited higher short-term BPV that was not influenced by diet.

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Fig. 1: Plasma hormone levels across the three diets.
Fig. 2: 24 h BP in men and women across the three diets.
Fig. 3: 24 h BP assessed by average real variability in men and women across the three diets.

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Data availability

Data are available upon request from the corresponding author.

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Acknowledgements

We would like to thank our study coordinator Liza Walker, our research nurse, Wendy Nichols and the study dietitians, Sofia Sanchez and Kristina Krieger for their time and effort on this project.

Funding

This work was funded by the National Institutes of Health (P20GM113125 and 1R01HL145055).

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Authors and Affiliations

  1. Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA

    Macarena Ramos-Gonzalez, Katarina Smiljanec, Alexis U. Mbakwe, Andrea J. Lobene, William B. Farquhar & Shannon L. Lennon

  2. Biostatistics Core Facility, University of Delaware, Newark, DE, USA

    Ryan T. Pohlig

  3. Epidemiology Program, University of Delaware, Newark, DE, USA

    Ryan T. Pohlig

Authors
  1. Macarena Ramos-Gonzalez
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  2. Katarina Smiljanec
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  6. William B. Farquhar
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  7. Shannon L. Lennon
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Contributions

WBF and SLL conceived and designed research; MRG, KS, and AUM performed experiments; MRG, AJL, and RTP analyzed data; MRG, AJL, RTP, and SLL interpreted results of experiments; MRG and AJL prepared figures; MRG and AJL drafted manuscript; MRG, KS, AUM, AJL, RTP, WBF and SLL edited and revised manuscript; MRG, KS, AUM, AJL, RTP, WBF and SLL approved final version of manuscript.

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Correspondence to Shannon L. Lennon.

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Ramos-Gonzalez, M., Smiljanec, K., Mbakwe, A.U. et al. Sex influences blood pressure but not blood pressure variability in response to dietary sodium and potassium in salt-resistant adults. J Hum Hypertens 38, 62–69 (2024). https://doi.org/10.1038/s41371-023-00855-5

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