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Am J Hypertens. 2015 May;28(5):640-8. doi: 10.1093/ajh/hpu193. Epub 2014 Nov 4.

Racial differences in abnormal ambulatory blood pressure monitoring measures: Results from the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Author information

1
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA; pmuntner@uab.edu.
2
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA;
3
Department of Medicine, Columbia University, New York, New York, USA;
4
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA;
5
Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA;
6
Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.

Abstract

BACKGROUND:

Several ambulatory blood pressure monitoring (ABPM) measures have been associated with increased cardiovascular disease risk independent of clinic blood pressure (BP). African Americans have higher clinic BP compared with Whites but few data are available on racial differences in ABPM measures.

METHODS:

We compared ABPM measures between African American (n = 178) and White (n = 103) participants at the Year 5 Coronary Artery Risk Development in Young Adults study visit. BP was measured during a study visit and the second and third measurements were averaged. ABPM was conducted over the following 24 hours.

RESULTS:

Mean ± SD age of participants was 29.8 ± 3.8 years and 30.8 ± 3.5 years for African Americans and Whites, respectively. Mean daytime systolic BP (SBP) was 3.90 (SD 1.18) mm Hg higher among African Americans compared with Whites (P < 0.001) after age-gender adjustment and 1.71 (SD 1.03) mm Hg higher after multivariable adjustment including mean clinic SBP (P = 0.10). After multivariable adjustment including mean clinic SBP, nighttime SBP was 4.83 (SD 1.11) mm Hg higher among African Americans compared with Whites (P < 0.001). After multivariable adjustment, the African Americans were more likely than Whites to have nocturnal hypertension (prevalence ratio: 2.44, 95% CI: 0.99-6.05) and nondipping (prevalence ratio: 2.50, 95% CI: 1.39-4.48). The prevalence of masked hypertension among African Americans and Whites was 4.4% and 2.1%, respectively, (P = 0.49) and white coat hypertension was 3.3% and 3.9%, respectively (P = 0.99). Twenty-four hour BP variability on ABPM was higher among African Americans compared with Whites.

CONCLUSIONS:

These data suggest racial differences in several ABPM measures exist.

KEYWORDS:

ambulatory blood pressure; blood pressure; disparities; hypertension; race.

PMID:
25376639
PMCID:
PMC4415060
DOI:
10.1093/ajh/hpu193
[Indexed for MEDLINE]
Free PMC Article

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