Journal of the American Heart Association
October 16, 2026 · via Europe PMC
Psychological Stress and the Diurnal Patterns of Sodium Excretion and Blood Pressure: Results From the SABRE Study.
Fang C, Barrett M, Cepeda M, +11 more, Shimbo D
AI summary — for doctors, generated from the abstract only
A smaller sodium excretion response to mental stress was linked to a poorer day-night pattern of sodium excretion, which in turn was linked to less nocturnal blood pressure dipping.
What was studied
Laboratory study in apparently healthy adults from the SABRE study measuring urinary sodium excretion before and after mental stress tasks, followed by 24-hour ambulatory blood pressure monitoring and separate awake and asleep urine collections.
Key findings
- A smaller stress-induced urinary sodium excretion rate was associated with a lower awake-to-asleep sodium excretion ratio (n=180, B=0.2253, 95% CI 0.0490-0.4016).
- A lower awake-to-asleep sodium excretion ratio was associated with lower systolic blood pressure dipping (n=175, B=1.0127, 95% CI 0.0599-1.9656).
Clinical relevance
The work suggests a possible pathway by which psychological stress impairs blood pressure dipping, via reduced sodium excretion, which may be relevant to understanding nondipping and cardiovascular risk.
Who should care
Limitations
Associations are observational with modest sample sizes (175 to 180), and the second confidence interval is close to zero. Participants were apparently healthy, and the abstract does not show that the pathway is causal.
Stress-related changes in sodium handling may help explain reduced nighttime blood pressure dipping, but causality and clinical use remain untested.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
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.
DOI
10.1161/JAHA.126.050471
PMID
42885782
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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