Abstract 20452: Blood Pressure Control and Dipping Patterns in Patients With Resistant Hypertension: Combined Effects of Aldosterone and Sodium

Background: High sodium intake and hyperaldosteronism are independently linked to increased cardiovascular morbidity and mortality. Hyperaldosteronism contributes to resistant hypertension (RHTN) and is associated with higher 24- hour ambulatory blood pressure (BP) levels. Nocturnal hypertension and non-dipping are associated with increased CV risk, but mechanisms are not fully elucidated. Objective: This study was designed to determine if high dietary sodium intake, and /or hyperaldosteronism mediate the development of abnormal diurnal BP patterns and nocturnal hypertension. Methods: A single-center cohort of 326 African American (AA) and Caucasian patients with RHTN were evaluated by assessing plasma renin activity (PRA), 24-hr urinary aldosterone (UAldo), sodium (UNa+) levels, and 24-hr ambulatory blood pressure monitoring (ABPM). Daytime, nighttime, and 24-hr BP levels and dipping patterns were determined. High sodium excretion was defined as UNa+ > 200 mEq/24hr and hyperaldosteronism was defined as U...