Relationship of circadian pattern of urine sodium excretion to hypertension and obstructive sleep apnoea
Bibliographic record
Abstract
OBJECTIVES: Obstructive sleep apnoea (OSA) and hypertension frequently coexist, and both are associated with higher night-time than daytime urine sodium excretion rate (UNaV). However, the relative contribution of each condition is unknown. We compared the circadian pattern of UNaV in hypertensive and normotensive patients with and without OSA. METHODS: Hypertensive [blood pressure (BP) >140/90 or on antihypertensive medications, excluding diuretics] and normotensive (BP <135/85) patients underwent overnight polysomnography to determine the presence or absence of OSA (apnoea-hypopnoea index ≥10 or <10, respectively), same-day 24-h urine collection divided into day and night-time samples and automated evening BP measurement. RESULTS: Twenty-six hypertensive (9 without and 17 with OSA) and 26 normotensive (15 without and 11 with OSA) patients were studied. Night-time UNaV was higher in the hypertensive than the normotensive patients. Whereas in the normotensive patients night-time UNaV was unaffected by OSA, in the hypertensive patients, it was higher in those with than without OSA (P = 0.009 for OSA × hypertension interaction). Night : day UNaV ratio was higher in hypertensive than normotensive patients, but was not significantly affected by OSA in either group. On multivariate analysis, SBP and apnoea-hypopnoea index were independent predictors of night-time UNaV (model r = 0.574, P < 0.001) and night : day UNaV ratio (model r = 0.397, P < 0.001). However, SBP was the strongest independent predictor. CONCLUSIONS: In hypertensive patients, OSA exacerbates the reversal of the normal circadian sodium excretion pattern by elevating nocturnal UNaV, possibly via its BP-elevating effects. However, OSA does not affect nocturnal UNaV in normotensive patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".