Elevated Blood Pressure and Aldosterone Dysregulation in Young Black Women versus White Women on Controlled Sodium Diets
Yan Emily Yuan, Andrea V Haas, Bernard Rosner, Gail K Adler, Gordon H Williams- Biochemistry (medical)
- Clinical Biochemistry
- Endocrinology
- Biochemistry
- Endocrinology, Diabetes and Metabolism
Abstract
Context
Black women have a higher prevalence of hypertension as compared to White women. Differences in dietary sodium intake have been implicated as a contributing factor for the disparities in hypertension.
Objection
Our objective was to understand whether young Black women would have higher systolic blood pressure (SBP) than White women even on controlled sodium diets, and to determine whether SBP differences were due to differences in dietary sodium intake and/or aldosterone regulation.
Design
The analyses included 525 hypertensive and normotensive women (ages 18-71) from the International Hypertensive Pathotype consortium, who were maintained on liberal sodium (>200 mEq sodium/day; LIB) and restricted sodium (10mEq sodium/day; RES) diets.
Results
Multivariate regression analyses (adjusted for age, race, study site, body mass index) found that Black women (age 18-50) had significantly higher SBP than White women on both sodium diets: + 8.7 ± 2.7 mmHg (p-value = 0.002) on LIB diet, + 8.5 ± 2.5 mmHg (p-value = 0.001) on RES diet. Even among 18–35-year-olds—who were normotensive and non-obese—Black women had higher SBP: + 7.9 ± 2.4 mmHg(p-value = 0.001) on LIB diet and +7.6 ± 2.7 mmHg (p-value = 0.005) on RES diet. Younger Black women also had higher plasma aldosterone concentration to plasma renin activity ratio (ARR) on both LIB and RES diets as well as a higher sodium-modulated aldosterone suppression-stimulation index—an indicator of aldosterone dysregulation. In younger Black women—but not in White women—there was a significant association between SBP and ARR on both LIB and RES diets.
Conclusion
Young Black women had increased SBP and ARR as compared to White women on LIB and RES diets, which offer insights into the possible mechanisms for the increased hypertension and cardiovascular disease risk in an at-risk and understudied population.