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Association of prevalent hypertension with 24-hour urinary excretion of calcium, citrate, and other factors.

Abstract

BACKGROUND

The relation between hypertension and the urinary excretion of calcium, citrate, and other factors is unclear. It has been proposed that increased urinary calcium excretion is a central feature of essential hypertension. Metabolic acidosis also may be associated with hypertension and decreases urinary citrate levels.

METHODS

To compare the urine composition of individuals with and without hypertension, we studied 24-hour urinary excretion of calcium, citrate, oxalate, uric acid, sodium, magnesium, potassium, phosphorus, and creatinine and pH in a subset of participants with and without nephrolithiasis in the Nurses' Health Study I (older women; N = 1,284), Nurses' Health Study II (younger women; N = 952), and the Health Professionals Follow-up Study (men; N = 788). Logistic regression models adjusted for age, weight, dietary intake, and urinary factors.

RESULTS

In participants with and without nephrolithiasis, citrate was the only urinary factor consistently related to hypertension. Compared with those in the lowest quartile of urinary citrate excretion, multivariate odds ratios of prevalent hypertension in the highest quartile were 0.37 (95% confidence interval [CI], 0.24 to 0.55; P trend < 0.001) for older women, 0.54 (95% CI, 0.32 to 0.92; P trend = 0.03) for younger women, and 0.27 (95% CI, 0.16 to 0.45; P trend < 0.001) for men. Urinary calcium levels were not related consistently to hypertension. Excluding participants with single 24-hour urine collections and those administered thiazide diuretics or angiotensin-converting enzyme inhibitors did not change the results.

CONCLUSION

Lower urinary citrate excretion is associated independently with prevalent hypertension. Factors that regulate urinary citrate excretion may play a role in hypertension.

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  • Authors+Show Affiliations

    ,

    Renal Division, Department of Medicine, Brigham Women's Hospital, Harvard Medical School, Boston, MA, USA. entaylor@partners.org

    , ,

    Source

    MeSH

    Adult
    Age Factors
    Aged
    Calcium
    Citric Acid
    Female
    Humans
    Hypertension
    Kidney Calculi
    Middle Aged
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    16632016

    Citation

    Taylor, Eric N., et al. "Association of Prevalent Hypertension With 24-hour Urinary Excretion of Calcium, Citrate, and Other Factors." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 47, no. 5, 2006, pp. 780-9.
    Taylor EN, Mount DB, Forman JP, et al. Association of prevalent hypertension with 24-hour urinary excretion of calcium, citrate, and other factors. Am J Kidney Dis. 2006;47(5):780-9.
    Taylor, E. N., Mount, D. B., Forman, J. P., & Curhan, G. C. (2006). Association of prevalent hypertension with 24-hour urinary excretion of calcium, citrate, and other factors. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 47(5), pp. 780-9.
    Taylor EN, et al. Association of Prevalent Hypertension With 24-hour Urinary Excretion of Calcium, Citrate, and Other Factors. Am J Kidney Dis. 2006;47(5):780-9. PubMed PMID: 16632016.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association of prevalent hypertension with 24-hour urinary excretion of calcium, citrate, and other factors. AU - Taylor,Eric N, AU - Mount,David B, AU - Forman,John P, AU - Curhan,Gary C, PY - 2005/12/08/received PY - 2006/01/31/accepted PY - 2006/4/25/pubmed PY - 2006/6/27/medline PY - 2006/4/25/entrez SP - 780 EP - 9 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 47 IS - 5 N2 - BACKGROUND: The relation between hypertension and the urinary excretion of calcium, citrate, and other factors is unclear. It has been proposed that increased urinary calcium excretion is a central feature of essential hypertension. Metabolic acidosis also may be associated with hypertension and decreases urinary citrate levels. METHODS: To compare the urine composition of individuals with and without hypertension, we studied 24-hour urinary excretion of calcium, citrate, oxalate, uric acid, sodium, magnesium, potassium, phosphorus, and creatinine and pH in a subset of participants with and without nephrolithiasis in the Nurses' Health Study I (older women; N = 1,284), Nurses' Health Study II (younger women; N = 952), and the Health Professionals Follow-up Study (men; N = 788). Logistic regression models adjusted for age, weight, dietary intake, and urinary factors. RESULTS: In participants with and without nephrolithiasis, citrate was the only urinary factor consistently related to hypertension. Compared with those in the lowest quartile of urinary citrate excretion, multivariate odds ratios of prevalent hypertension in the highest quartile were 0.37 (95% confidence interval [CI], 0.24 to 0.55; P trend < 0.001) for older women, 0.54 (95% CI, 0.32 to 0.92; P trend = 0.03) for younger women, and 0.27 (95% CI, 0.16 to 0.45; P trend < 0.001) for men. Urinary calcium levels were not related consistently to hypertension. Excluding participants with single 24-hour urine collections and those administered thiazide diuretics or angiotensin-converting enzyme inhibitors did not change the results. CONCLUSION: Lower urinary citrate excretion is associated independently with prevalent hypertension. Factors that regulate urinary citrate excretion may play a role in hypertension. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/16632016/Association_of_prevalent_hypertension_with_24_hour_urinary_excretion_of_calcium_citrate_and_other_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(06)00125-9 DB - PRIME DP - Unbound Medicine ER -