# Psychological stress, and circadian patterns of sodium excretion and blood pressure

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $145,319

## Abstract

The proposed study will examine urinary sodium excretion induced by psychological stress and its
diurnal pattern as a novel biological mechanism that may underlie an abnormal diurnal pattern of
blood pressure (BP). BP follows a diurnal rhythm, for which it is highest during the daytime, and falls to its
lowest level during the nighttime (i.e. BP dipping). The diurnal pattern of BP over 24 hours can be assessed
using ambulatory BP monitoring (ABPM). An abnormal diurnal pattern of BP on ABPM, defined by reduced BP
dipping or elevated nighttime BP, is associated with an increased risk of cardiovascular disease (CVD) events.
Psychological stress is associated with an abnormal diurnal pattern of BP. However, the underlying
mechanisms remain unknown. An exposure to an acute stressor using a mental stress task normally increases
urinary sodium excretion. However, there is substantial between-person variability in the degree of stress-
induced sodium excretion, such that some individuals have sodium retention after stress provocation. It has
been hypothesized that when urinary sodium excretion does not occur during the daytime, urinary sodium
excretion is shifted toward the nighttime, which is accompanied by an increase in nighttime BP. Therefore,
individuals with lower stress-induced sodium excretion who experience psychological stress during the daytime
may have a shift of urinary sodium excretion from the daytime to nighttime periods due to an inability to excrete
sodium during the daytime. This altered diurnal pattern of urinary sodium excretion may be associated with a
smaller decline in BP from the daytime to nighttime, leading to reduced BP dipping. The study will be
conducted both in the laboratory setting and in the naturalistic environment with a multi-ethnic sample of 211
adult community participants from upper Manhattan. In the laboratory, urinary sodium excretion in response to
mental stress tasks will be examined. In the naturalistic environment, measurement of the diurnal pattern of
sodium excretion, ABPM, wrist actigraphy, and ecological momentary assessments of perceived stress will be
performed. We hypothesize that lower stress-induced sodium excretion rate in the laboratory will be associated
with lower daytime-to-nighttime ratio of urinary sodium excretion rate in the naturalistic environment; and lower
daytime-to-nighttime ratio of urinary sodium excretion rate will be associated with reduced BP dipping. We will
also examine whether the association between urinary sodium excretion after provoked stress and the diurnal
pattern of sodium excretion is modified by higher ecological momentary levels of stress, experienced during
the daytime. The study is highly innovative as it will test not previously proposed theoretical linkages among
urinary excretion in response to stress provoked in the laboratory, ecological stress, and the diurnal patterns of
sodium excretion and BP in the naturalistic environment. The study has high clinical sign...

## Key facts

- **NIH application ID:** 10130945
- **Project number:** 3R01HL137818-03S1
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** DAICHI SHIMBO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $145,319
- **Award type:** 3
- **Project period:** 2018-05-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10130945

## Citation

> US National Institutes of Health, RePORTER application 10130945, Psychological stress, and circadian patterns of sodium excretion and blood pressure (3R01HL137818-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10130945. Licensed CC0.

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