Associations of awake and asleep blood pressure and blood pressure dipping with abnormalities of cardiac structure: The Coronary Artery Risk Development in Young Adults study

Natalie A. Bello*, Byron C. Jaeger, John N. Booth, Marwah Abdalla, D. Edmund Anstey, Daniel N. Pugliese, Cora E. Lewis, Samuel S. Gidding, Donald Lloyd-Jones, Sanjiv J. Shah, Joseph E. Schwartz, James M. Shikany, Paul Muntner, Daichi Shimbo

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objectives:To evaluate the associations of high awake blood pressure (BP), high asleep BP, and nondipping BP, determined by ambulatory BP monitoring (ABPM), with left ventricular hypertrophy (LVH) and geometry.Methods:Black and white participants (n = 687) in the Coronary Artery Risk Development in Young Adults study underwent 24-h ABPM and echocardiography at the Year 30 Exam in 2015-2016. The prevalence and prevalence ratios of LVH were calculated for high awake SBP (≥130 mmHg), high asleep SBP (≥110 mmHg), the cross-classification of high awake and asleep SBP, and nondipping SBP (percentage decline in awake-to-asleep SBP < 10%). Odds ratios for abnormal left ventricular geometry associated with these phenotypes were calculated.Results:Overall, 46.0 and 49.1% of study participants had high awake and asleep SBP, respectively, and 31.1% had nondipping SBP. After adjustment for demographics and clinical characteristics, high awake SBP was associated with a prevalence ratio for LVH of 2.79 [95% confidence interval (95% CI) 1.63-4.79]. High asleep SBP was also associated with a prevalence ratio for LVH of 2.19 (95% CI 1.25-3.83). There was no evidence of an association between nondipping SBP and LVH (prevalence ratio 0.70, 95% CI 0.44-1.12). High awake SBP with or without high asleep SBP was associated with a higher odds ratio of concentric remodeling and hypertrophy.Conclusion:Awake and asleep SBP, but not the decline in awake-to-asleep SBP, were associated with increased prevalence of cardiac end-organ damage.

Original languageEnglish (US)
Pages (from-to)102-110
Number of pages9
JournalJournal of hypertension
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • ambulatory blood pressure monitoring
  • left ventricular hypertrophy
  • left ventricular remodeling
  • nondipping blood pressure
  • target organ damage

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Bello, N. A., Jaeger, B. C., Booth, J. N., Abdalla, M., Anstey, D. E., Pugliese, D. N., Lewis, C. E., Gidding, S. S., Lloyd-Jones, D., Shah, S. J., Schwartz, J. E., Shikany, J. M., Muntner, P., & Shimbo, D. (2020). Associations of awake and asleep blood pressure and blood pressure dipping with abnormalities of cardiac structure: The Coronary Artery Risk Development in Young Adults study. Journal of hypertension, 38(1), 102-110. https://doi.org/10.1097/HJH.0000000000002221