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5. Validation of spot urine in estimating 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets in healthy adults.

Author

Groenland, Eline H., Vendeville, Jean-Paul A. C., Bots, Michiel L., Visseren, Frank L. J., Musson, Ruben E. A., and Spiering, Wilko

Subjects
*DIETARY sodium, *HIGH-salt diet, *SALT-free diet, *POTASSIUM, *SODIUM, *THIRST
Abstract

To evaluate the validity of spot urine assay methods in estimating the 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets. Twelve healthy volunteers were asked to adhere to 3 dietary sodium targets (3.3–5.0g/day,<3.3 g/day and >5.0 g/day) for three consecutive weeks and to measure salt excretion daily in spot urine samples using a self-monitoring device. On day 7 of each week, 24-h urine was collected to compare measured with estimated 24-h salt excretion (by the Kawasaki, Tanaka and INTERSALT equations). Correlation coefficients relating measured and estimated 24-h sodium excretion were low and not significant for Kawasaki and INTERSALT and moderate for the Tanaka equation (τ 0.56–0.64,p<.05). Bland–Altman plots showed considerable differences between estimated and measured sodium excretion across all salt diets. Over 40% of the participants showed an absolute difference between measured and estimated 24-h sodium of more than 1000 mg/day. The correlation coefficients between 24-h and spot Na/K ratio were 0.67, 0.94 and 0.85(p<.05), and mean differences were 0.59, 0.06 and 0.48 for the intermediate, low and high sodium diets, respectively. These findings do not support estimation of individual 24-h salt excretion from spot urine by the Kawasaki, Tanaka, or INTERSALT formula. Accurate monitoring of salt intake is essential to improve BP control. At present, measurement of sodium and potassium excretion in multiple non-consecutive 24-h urinary collections is considered the gold standard for measuring dietary sodium intake. However, this method is burdensome, time-consuming and error prone. Therefore, we assessed and compared the validity of three formula-based approaches to estimate 24-h urinary sodium and potassium excretion and the Na/K ratio from spot urine samples measured by a self-monitoring device under three different sodium diets using 24-h urine collections as the reference. We conclude that use of three commonly used equations that estimate 24-h urinary sodium and potassium excretion result in substantial bias, poor precision and poor accuracy and are therefore not recommended. The Na/K ratio based on multiple casual urine samples may be a useful, low-burden, low-cost alternative method to 24-h urine collection for monitoring daily salt intake. [ABSTRACT FROM AUTHOR]

Published
2023
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6. Validation of spot urine in estimating 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets in healthy adults

Author

Interne Geneeskunde Vasculaire, Unit Opleiding Aios, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, CDL Cluster 24/7 centraal laboratorium, MS Interne Geneeskunde, Groenland, Eline H., Vendeville, Jean Paul A.C., Bots, Michiel L., Visseren, Frank L.J., Musson, Ruben E.A., Spiering, Wilko, Interne Geneeskunde Vasculaire, Unit Opleiding Aios, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, CDL Cluster 24/7 centraal laboratorium, MS Interne Geneeskunde, Groenland, Eline H., Vendeville, Jean Paul A.C., Bots, Michiel L., Visseren, Frank L.J., Musson, Ruben E.A., and Spiering, Wilko

Published
2023

9. The effect of endovascular baroreflex amplification on central sympathetic nerve circuits and cerebral blood flow in patients with resistant hypertension: A functional MRI study

Author

Groenland, Eline H, van Kleef, Monique E A M, Hendrikse, Jeroen, Spiering, Wilko, Siero, Jeroen C W, Groenland, Eline H, van Kleef, Monique E A M, Hendrikse, Jeroen, Spiering, Wilko, and Siero, Jeroen C W

Abstract

BACKGROUND: Endovascular baroreflex amplification (EVBA) by implantation of the MobiusHD is hypothesized to lower blood pressure by decreasing sympathetic activity through the mechanism of the baroreflex. In the present exploratory study we investigated the impact of MobiusHD implantation on central sympathetic nerve circuits and cerebral blood flow (CBF) in patients with resistant hypertension.MATERIALS AND METHODS: In thirteen patients, we performed blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) at rest and during Valsalva maneuvers, before and 3 months after EVBA. Data were analyzed using a whole-brain approach and a brainstem-specific analysis. CBF was assessed using arterial spin labeling MRI.RESULTS: Resting-state fMRI analysis did not reveal significant differences in functional connectivity at 3 months after EVBA. For the Valsalva maneuver data, the whole-brain fMRI analysis revealed significantly increased activation in the posterior and anterior cingulate, the insular cortex, the precuneus, the left thalamus and the anterior cerebellum. The brainstem-specific fMRI analysis showed a significant increase in BOLD activity in the right midbrain 3 months after EVBA. Mean gray matter CBF (partial volume corrected) decreased significantly from 48.9 (9.9) ml/100 gr/min at baseline to 43.4 (13.0) ml/100 gr/min (p = 0.02) at 3 months.CONCLUSIONS: This first fMRI pilot study in patients with resistant hypertension treated with EVBA showed a significant increase in BOLD activity during the Valsalva maneuver in brain regions related to sympathetic activity. No notable signal intensity changes were observed in brain areas involved in the baroreflex circuit. Future randomized controlled studies are needed to investigate whether the observed changes are directly caused by EVBA.CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov, identifier: NCT02827032.

Published
2022

10. Smartphone Application-Assisted Home Blood Pressure Monitoring Compared With Office and Ambulatory Blood Pressure Monitoring in Patients With Hypertension: the AMUSE-BP Study

Author

Interne Geneeskunde Vasculaire, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Interne Geneeskunde, Groenland, Eline H., Vendeville, Jean Paul A.C., Bemelmans, Remy H.H., Monajemi, Houshang, Bots, Michiel L., Visseren, Frank L.J., Spiering, Wilko, Interne Geneeskunde Vasculaire, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Interne Geneeskunde, Groenland, Eline H., Vendeville, Jean Paul A.C., Bemelmans, Remy H.H., Monajemi, Houshang, Bots, Michiel L., Visseren, Frank L.J., and Spiering, Wilko

Published
2022

11. Clinical characteristics do not reliably identify non-adherence in patients with uncontrolled hypertension

Author

Interne Geneeskunde Vasculaire, Circulatory Health, Apotheek Klinische Farmacie, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Interne Geneeskunde, Groenland, Eline H., Dasgupta, Indranil, Visseren, Frank L.J., van der Elst, Kim C.M., Lorde, Nathan, Lawson, Alexander J., Bots, Michiel L., Spiering, Wilko, Interne Geneeskunde Vasculaire, Circulatory Health, Apotheek Klinische Farmacie, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Interne Geneeskunde, Groenland, Eline H., Dasgupta, Indranil, Visseren, Frank L.J., van der Elst, Kim C.M., Lorde, Nathan, Lawson, Alexander J., Bots, Michiel L., and Spiering, Wilko

Published
2022

12. Number of measurement days needed for obtaining a reliable estimate of home blood pressure and hypertension status

Author

Interne Geneeskunde Vasculaire, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Interne Geneeskunde, Groenland, Eline H., Bots, Michiel L., Visseren, Frank L.J., McManus, Richard J., Spiering, Wilko, Interne Geneeskunde Vasculaire, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Interne Geneeskunde, Groenland, Eline H., Bots, Michiel L., Visseren, Frank L.J., McManus, Richard J., and Spiering, Wilko

Published
2022

13. The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease

Author

Interne Geneeskunde Vasculaire, Unit Opleiding Aios, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Zorgeenheid Vaatchirurgie Medisch, Brain, Regenerative Medicine and Stem Cells, CCU Cardiologie, Team Medisch, Neurologen, MS Nefrologie, MS Interne Geneeskunde, Groenland, Eline H., Vendeville, Jean Paul, Bots, Michiel L., de Borst, Gert Jan, Nathoe, Hendrik M., Ruigrok, Ynte M., Blankestijn, Peter J., Visseren, Frank L.J., Spiering, Wilko, Interne Geneeskunde Vasculaire, Unit Opleiding Aios, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Zorgeenheid Vaatchirurgie Medisch, Brain, Regenerative Medicine and Stem Cells, CCU Cardiologie, Team Medisch, Neurologen, MS Nefrologie, MS Interne Geneeskunde, Groenland, Eline H., Vendeville, Jean Paul, Bots, Michiel L., de Borst, Gert Jan, Nathoe, Hendrik M., Ruigrok, Ynte M., Blankestijn, Peter J., Visseren, Frank L.J., and Spiering, Wilko

Published
2022

15. Plasma Trough Concentrations of Antihypertensive Drugs for the Assessment of Treatment Adherence

Author

Groenland, Eline H., van Kleef, Monique E.A.M., Bots, Michiel L., Visseren, Frank L.J., van der Elst, Kim C.M., and Spiering, Wilko

Subjects
hypertension, Antihypertensive Treatment, Original Articles, meta-analysis, Treatment Adherence and Compliance, biochemical adherence assessment, Hydrochlorothiazide, trough concentration, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Humans, Valsartan, Amlodipine, Antihypertensive Agents
Abstract

Supplemental Digital Content is available in the text., Biochemical drug screening by liquid chromatography-tandem mass spectrometry in plasma is an accurate method for the quantification of plasma concentrations of antihypertensive medications in patients with hypertension. Trough concentrations could possibly be used as drug-specific cutoff values in the biochemical assessment of (non-)adherence. We performed a literature review and meta-analysis of pharmacokinetic studies to determine plasma trough concentrations of amlodipine, hydrochlorothiazide, and valsartan. PubMed was searched for pharmacokinetic studies up to September 2020. Eligible studies reported steady-state mean trough concentration and their variance. Pooled trough concentrations were estimated using a three-level random effects meta-analytic model. Moderator analyses were performed to explore sources of heterogeneity. One thousand three hundred eighteen potentially relevant articles were identified of which 45 were eligible for inclusion. The pooled mean trough concentration was 9.2 ng/mL (95% CI, 7.5–10.8) for amlodipine, 41.0 ng/mL (95% CI, 17.4–64.7) for hydrochlorothiazide, and 352.9 ng/mL (95% CI, 243.5–462.3) for valsartan. Substantial heterogeneity was present for all 3 pooled estimates. Moderator analyses identified dosage as a significant moderator for the pooled trough concentration of amlodipine (β1=0.9; P

Published
2020

17. Plasma Trough Concentrations of Antihypertensive Drugs for the Assessment of Treatment Adherence: A Meta-Analysis

Author

Interne Geneeskunde Vasculaire, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Apotheek Klinische Farmacie, MS Interne Geneeskunde, Groenland, Eline H, van Kleef, Monique E A M, Bots, Michiel L, Visseren, Frank L J, van der Elst, Kim C M, Spiering, Wilko, Interne Geneeskunde Vasculaire, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Apotheek Klinische Farmacie, MS Interne Geneeskunde, Groenland, Eline H, van Kleef, Monique E A M, Bots, Michiel L, Visseren, Frank L J, van der Elst, Kim C M, and Spiering, Wilko

Published
2021

19. The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease.

Author

Groenland, Eline H., Vendeville, Jean-Paul, Bots, Michiel L., de Borst, Gert Jan, Nathoe, Hendrik M., Ruigrok, Ynte M., Blankestijn, Peter J., Visseren, Frank L. J., and Spiering, Wilko

Subjects
*MAJOR adverse cardiovascular events, *POTASSIUM, *EXCRETION, *PROPORTIONAL hazards models, *CARDIOVASCULAR diseases risk factors, *DRUG-eluting stents, CARDIOVASCULAR disease related mortality
Abstract

Background: Most evidence on the relationship between sodium and potassium intake and cardiovascular disease originated from general population studies. This study aimed to evaluate the relation between estimated 24-hour sodium and potassium urinary excretion and the risk of recurrent vascular events and mortality in patients with vascular disease. Methods: 7561 patients with vascular disease enrolled in the UCC-SMART cohort (1996–2015) were included. Twenty-four hour sodium and potassium urinary excretion were estimated (Kawasaki formulae) from morning urine samples. Cox proportional hazard models with restricted cubic splines were used to evaluate the relation between estimated urinary salt excretion and major adverse cardiovascular events (MACE; including myocardial infarction, stroke, cardiovascular mortality) and all-cause mortality. Results: After a median follow-up of 7.4 years (interquartile range: 4.1–11.0), the relations between estimated 24-hour sodium urinary excretion and outcomes were J-shaped with nadirs of 4.59 gram/day for recurrent MACE and 4.97 gram/day for all-cause mortality. The relation between sodium-to-potassium excretion ratio and outcomes were also J-shaped with nadirs of 2.71 for recurrent MACE and 2.60 for all-cause mortality. Higher potassium urinary excretion was related to an increased risk of both recurrent MACE (HR 1.25 per gram potassium excretion per day; 95%CI 1.13–1.39) and all cause-mortality (HR 1.13 per gram potassium excretion per day; 95%CI 1.03–1.25). Conclusions: In patients with established vascular disease, lower and higher sodium intake were associated with higher risk of recurrent MACE and all-cause mortality. Higher estimated 24-hour potassium urinary excretion was associated with a higher risk of recurrent MACE and all-cause mortality. [ABSTRACT FROM AUTHOR]

Published
2022
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