Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Issue 2 (5th February 2019)

• Record Type: Journal Article
• Authors: Booth, John N.; Anstey, D. Edmund; Bello, Natalie A.; Jaeger, Byron C.; Pugliese, Daniel N.; Thomas, Stephen Justin; Deng, Luqin; Shikany, James M.; Lloyd‐Jones, Donald; Schwartz, Joseph E.; Lewis, Cora E.; Shimbo, Daichi; Muntner, Paul
• Is Part Of: Journal of clinical hypertension. Volume 21:Issue 2(2019)
• Page Start: 184
• Page End: 192
• Publication Date: 2019-02-05
• Subjects: ambulatory blood pressure monitoring -- hypertension -- nocturnal hypertension -- non‐dipping blood pressure -- race and sex; Hypertension -- Periodicals; 616.132
• DOI: 10.1111/jch.13474
• Languages: English
• ISSNs: 1524-6175

Abstract

Abstract : Nocturnal hypertension and non‐dipping blood pressure are each associated with increased risk of cardiovascular disease. We determined differences in nocturnal hypertension and non‐dipping systolic/diastolic blood pressure among black and white men and women who underwent 24‐hour ambulatory blood pressure monitoring at the Coronary Artery Risk Development in Young Adults study Year 30 Exam in 2015‐2016. Asleep and awake periods were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as mean asleep systolic/diastolic blood pressure ≥ 120/70 mm Hg. Non‐dipping systolic and diastolic blood pressure, separately, were defined as a decline in awake‐to‐asleep blood pressure < 10%. Among 767 participants, the prevalence of nocturnal hypertension was 18.4% and 44.4% in white and black women, respectively, and 36.4% and 59.9% in white and black men, respectively. After multivariable adjustment and compared with white women, the prevalence ratio (95% confidence interval) for nocturnal hypertension was 1.65 (1.18‐2.32) for black women, 1.63 (1.14‐2.33) for white men, and 2.01 (1.43‐2.82) for black men. The prevalence of non‐dipping systolic blood pressure was 21.5% and 41.0% in white and black women, respectively, and 20.2% and 37.9% in white and black men, respectively. Compared with white women, the multivariable‐adjusted prevalence ratio (95% confidence interval) for non‐dipping systolic blood pressure was 1.66 (1.18‐2.32), 0.91 (0.58‐1.42) and 1.66 (1.15‐2.39) among black women, white men, and black men, respectively. Non‐dipping diastolic blood pressure did not differ by race‐sex groups following multivariable adjustment. In conclusion, black women and men have a high prevalence of nocturnal hypertension and non‐dipping systolic blood pressure.