BACKGROUND: African Americans have higher rates of nocturnal hypertension and less nocturnal blood pressure (BP) dipping compared with whites. Although nocturnal hypertension is associated with increased cardiovascular morbidity and mortality, its clinical significance among those with normal daytime BP is unclear. This paper reports the prevalence and correlates of isolated nocturnal hypertension (INH) in a population-based cohort of African Americans enrolled in the Jackson Heart Study (JHS). METHODS: The study sample included 425 untreated, normotensive and hypertensive JHS participants who underwent 24-hour ambulatory BP monitoring (ABPM), echocardiography, and 24-hour urine collection. Multiple logistic regression and 1-way analysis of variance models were used to test the hypothesis that those with INH have worse target organ damage reflected by greater left ventricular (LV) mass and proteinuria compared with normotensive participants. RESULTS: Based on 24-hour ABP profiles, 19.1% of participants had INH. In age and sex-adjusted models, participants with INH had greater LV mass compared with those who were normotensive (P = 0.02), as well as about 3 times the odds of LV hypertrophy and proteinuria (Ps < 0.10). However, multivariable adjustment reduced the magnitude and statistical significance of each of these differences. CONCLUSIONS: INH was associated with increased LV mass compared with normo tension in a population-based cohort of African Americans enrolled in the JHS. There were trends toward a greater likelihood of LV hyper trophy and proteinuria among participants with INH vs. those who were normotensive. The clinical significance of the noted target organ damage should be explored in this population.
BACKGROUND: African Americans have higher rates of nocturnal hypertension and less nocturnal blood pressure (BP) dipping compared with whites. Although nocturnal hypertension is associated with increased cardiovascular morbidity and mortality, its clinical significance among those with normal daytime BP is unclear. This paper reports the prevalence and correlates of isolated nocturnal hypertension (INH) in a population-based cohort of African Americans enrolled in the Jackson Heart Study (JHS). METHODS: The study sample included 425 untreated, normotensive and hypertensive JHS participants who underwent 24-hour ambulatory BP monitoring (ABPM), echocardiography, and 24-hour urine collection. Multiple logistic regression and 1-way analysis of variance models were used to test the hypothesis that those with INH have worse target organ damage reflected by greater left ventricular (LV) mass and proteinuria compared with normotensive participants. RESULTS: Based on 24-hour ABP profiles, 19.1% of participants had INH. In age and sex-adjusted models, participants with INH had greater LV mass compared with those who were normotensive (P = 0.02), as well as about 3 times the odds of LV hypertrophy and proteinuria (Ps < 0.10). However, multivariable adjustment reduced the magnitude and statistical significance of each of these differences. CONCLUSIONS: INH was associated with increased LV mass compared with normo tension in a population-based cohort of African Americans enrolled in the JHS. There were trends toward a greater likelihood of LV hyper trophy and proteinuria among participants with INH vs. those who were normotensive. The clinical significance of the noted target organ damage should be explored in this population.
Entities:
Keywords:
Jackson Heart Study; ambulatory blood pressure monitoring; blood pressure; hypertension; nocturnal blood pressure; target organ damage.
Authors: Myra A Carpenter; Richard Crow; Michael Steffes; William Rock; Jeffrey Heilbraun; Gregory Evans; Thomas Skelton; Robert Jensen; Daniel Sarpong Journal: Am J Med Sci Date: 2004-09 Impact factor: 2.378
Authors: T Ohkubo; Y Imai; I Tsuji; K Nagai; N Watanabe; N Minami; J Kato; N Kikuchi; A Nishiyama; A Aihara; M Sekino; H Satoh; S Hisamichi Journal: Am J Hypertens Date: 1997-11 Impact factor: 2.689
Authors: Sonia Ancoli-Israel; Carl Stepnowsky; Joel Dimsdale; Matthew Marler; Mairav Cohen-Zion; Sherella Johnson Journal: Chest Date: 2002-10 Impact factor: 9.410
Authors: J A Staessen; W Birkenhäger; C J Bulpitt; R Fagard; A E Fletcher; P Lijnen; L Thijs; A Amery Journal: J Hypertens Date: 1993-04 Impact factor: 4.844
Authors: P Verdecchia; C Porcellati; G Schillaci; C Borgioni; A Ciucci; M Battistelli; M Guerrieri; C Gatteschi; I Zampi; A Santucci; C Santucci; G Reboldi Journal: Hypertension Date: 1994-12 Impact factor: 10.190
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Marwah Abdalla; Jeff Goldsmith; Paul Muntner; Keith M Diaz; Kristi Reynolds; Joseph E Schwartz; Daichi Shimbo Journal: Am J Hypertens Date: 2015-04-22 Impact factor: 2.689
Authors: Anne Marie O'Flynn; Jamie M Madden; Audrey J Russell; Ronan J Curtin; Patricia M Kearney Journal: Hypertens Res Date: 2015-04-02 Impact factor: 3.872
Authors: Faye S Routledge; Alan L Hinderliter; Judith McFetridge-Durdle; James A Blumenthal; Nicola J Paine; Andrew Sherwood Journal: Menopause Date: 2015-08 Impact factor: 2.953
Authors: Erica S Spatz; Josefa L Martinez-Brockman; Baylah Tessier-Sherman; Bobak Mortazavi; Brita Roy; Jeremy I Schwartz; Cruz M Nazario; Rohan Maharaj; Maxine Nunez; O Peter Adams; Matthew Burg; Marcella Nunez-Smith Journal: Ethn Dis Date: 2019-10-17 Impact factor: 1.847
Authors: Florian Rader; Stanley S Franklin; James Mirocha; Wanpen Vongpatanasin; Robert W Haley; Ronald G Victor Journal: Hypertension Date: 2019-09-16 Impact factor: 10.190
Authors: D Edmund Anstey; Lisandro D Colantonio; Yuichiro Yano; John N Booth Iii; Paul Muntner Journal: J Clin Hypertens (Greenwich) Date: 2018-07-06 Impact factor: 3.738