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

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

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Left Ventricular Hypertrophy
Young Adult
Coronary Vessels
Blood Pressure
Confidence Intervals
Odds Ratio
Hypertension
Ambulatory Monitoring
Ambulatory Blood Pressure Monitoring
Hypertrophy
Echocardiography
Demography
Phenotype

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

Cite this

Bello, Natalie A. ; Jaeger, Byron C. ; Booth, John N. ; Abdalla, Marwah ; Anstey, D. Edmund ; Pugliese, Daniel N. ; Lewis, Cora E. ; Gidding, Samuel S. ; Lloyd-Jones, Donald ; Shah, Sanjiv J. ; Schwartz, Joseph E. ; Shikany, James M. ; Muntner, Paul ; Shimbo, Daichi. / 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. In: Journal of hypertension. 2020 ; Vol. 38, No. 1. pp. 102-110.
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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.",
keywords = "ambulatory blood pressure monitoring, left ventricular hypertrophy, left ventricular remodeling, nondipping blood pressure, target organ damage",
author = "Bello, {Natalie A.} and Jaeger, {Byron C.} and Booth, {John N.} and Marwah Abdalla and Anstey, {D. Edmund} and Pugliese, {Daniel N.} and Lewis, {Cora E.} and Gidding, {Samuel S.} and Donald Lloyd-Jones and Shah, {Sanjiv J.} and Schwartz, {Joseph E.} and Shikany, {James M.} and Paul Muntner and Daichi Shimbo",
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Bello, NA, Jaeger, BC, Booth, JN, Abdalla, M, Anstey, DE, Pugliese, DN, Lewis, CE, Gidding, SS, Lloyd-Jones, D, Shah, SJ, Schwartz, JE, Shikany, JM, 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, vol. 38, no. 1, pp. 102-110. https://doi.org/10.1097/HJH.0000000000002221

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

In: Journal of hypertension, Vol. 38, No. 1, 01.01.2020, p. 102-110.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Associations of awake and asleep blood pressure and blood pressure dipping with abnormalities of cardiac structure

T2 - The Coronary Artery Risk Development in Young Adults study

AU - Bello, Natalie A.

AU - Jaeger, Byron C.

AU - Booth, John N.

AU - Abdalla, Marwah

AU - Anstey, D. Edmund

AU - Pugliese, Daniel N.

AU - Lewis, Cora E.

AU - Gidding, Samuel S.

AU - Lloyd-Jones, Donald

AU - Shah, Sanjiv J.

AU - Schwartz, Joseph E.

AU - Shikany, James M.

AU - Muntner, Paul

AU - Shimbo, Daichi

PY - 2020/1/1

Y1 - 2020/1/1

N2 - 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.

AB - 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.

KW - ambulatory blood pressure monitoring

KW - left ventricular hypertrophy

KW - left ventricular remodeling

KW - nondipping blood pressure

KW - target organ damage

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DO - 10.1097/HJH.0000000000002221

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JO - Journal of Hypertension

JF - Journal of Hypertension

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