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Association between the serum anion gap and blood pressure among patients at Harvard Vanguard Medical Associates

Journal of Human Hypertension volume 22, pages 122–125 (2008)Cite this article

Animal and human data suggest a link between endogenous acid production with elevations in blood pressure and the development of hypertension; increases in endogenous organic acid production can lead to a higher anion gap. We studied the cross-sectional association between the serum anion gap and blood pressure among 1057 non-diabetic patients who were not taking antihypertensive drugs, and who received their care at a multisite, multispecialty group practice in eastern Massachusetts. Using linear regression controlling for age, sex, race, BMI, estimated GFR and presence of impaired fasting glucose, every 1 mEq l −1 higher serum anion gap was associated with a 0.27 mm Hg ( P =0.08) higher systolic, 0.20 mm Hg ( P =0.05) higher diastolic and 0.22 mm Hg ( P =0.04) higher mean arterial pressure; these results suggest that endogenous acid production may raise the risk of hypertension.

Animal and human studies suggest a potential link between acid–base status and elevations in blood pressure (BP). Higher endogenous acid production leads to elevation of the serum anion gap (SAG); however, until recently the association between the SAG and BP had not yet been examined on a population level. We recently reported in the National Health and Nutrition Examination Survey (NHANES) that every 1 mEq l−1 increase in the SAG was associated with a significant 0.48 mm Hg increase in systolic and non-significant 0.16 mm Hg increase in diastolic BP.1 These findings have not yet been confirmed in a distinct cohort. Here, we report the association between the SAG and BP among 1057 patients followed at a multispecialty group practice.

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Acknowledgements

Funding sources: Sanofi-Aventis Pharmaceuticals; NIH Grant HL079929-01A2; NIH grant HL068041.

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Authors and Affiliations

  1. Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA

    J P Forman & E N Taylor

  2. Department of Ambulatory Care and Prevention, Obesity Prevention Program, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA

    S L Rifas-Shiman, K Lane & M W Gillman

  3. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    M W Gillman

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  1. J P Forman
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  2. S L Rifas-Shiman
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  3. E N Taylor
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  4. K Lane
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Correspondence to J P Forman.

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Supplementary Information accompanies the paper on the Journal of Human Hypertension website (http://www.nature.com/jhh)

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Forman, J., Rifas-Shiman, S., Taylor, E. et al. Association between the serum anion gap and blood pressure among patients at Harvard Vanguard Medical Associates. J Hum Hypertens 22, 122–125 (2008). https://doi.org/10.1038/sj.jhh.1002286

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