Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

John N. Booth; D. Edmund Anstey; Natalie A. Bello; Byron C. Jaeger; Daniel N. Pugliese; Stephen Justin Thomas; Luqin Deng; James M. Shikany; Donald Lloyd-Jones; Joseph E. Schwartz; Cora E. Lewis; Daichi Shimbo; Paul Muntner

doi:10.1111/jch.13474

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

John N. Booth^*, D. Edmund Anstey, Natalie A. Bello, Byron C. Jaeger, Daniel N. Pugliese, Stephen Justin Thomas, Luqin Deng, James M. Shikany, Donald Lloyd-Jones, Joseph E. Schwartz, Cora E. Lewis, Daichi Shimbo, Paul Muntner

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

29 Scopus citations

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.

Original language	English (US)
Pages (from-to)	184-192
Number of pages	9
Journal	Journal of Clinical Hypertension
Volume	21
Issue number	2
DOIs	https://doi.org/10.1111/jch.13474
State	Published - Feb 2019

Funding

through the HHSN268201300026C grant from the NIH/NHLBI. JES receives support through the American Heart Association grant SFRN 15SFRN2390002. CEL receives support through the HHSN268201300026C grant from the NIH/ NHLBI and American Heart Association grant SFRN 15SFRN2390002. DS receives support through R01 HL117323 and K24‐HL125704 from the NHLBI. PM receives research support American Heart Association grant SFRN 15SFRN2390002 John N. Booth III, PhD, Department of Epidemiology, University of Alabama at Birmingham, 1700 University Boulevard, Ryals Building 523B, Birmingham, AL 35294. Email: [email protected] Funding information The current study was supported by the American Heart Association grant SFRN 15SFRN2390002 and the Coronary Artery Risk Development in Young Adults Study (CARDIA) which is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). JNBIII receives research support through the American Heart Association grant SFRN 15SFRN2390002. DEA receives support through the 2T32HL007854‐21 grant from the NIH/NHLBI. NAB receives support through the K23HL136853 from the NIH/ NHLBI. BJ receives support through the American Heart Association grant SFRN 15SFRN2390002. DNP receives support through the T32 HL007854‐22 from the NIH/NHLBI. SJT receives support through the American Heart Association grant SFRN 15SFRN239002. JMS receives support through the HHSN268201300026C grant from the NIH/NHLBI. DLJ receives support Funding information The current study was supported by the American Heart Association grant SFRN 15SFRN2390002 and the Coronary Artery Risk Development in Young Adults Study (CARDIA) which is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). JNBIII receives research support through the American Heart Association grant SFRN 15SFRN2390002. DEA receives support through the 2T32HL007854-21 grant from the NIH/NHLBI. NAB receives support through the K23HL136853 from the NIH/NHLBI. BJ receives support through the American Heart Association grant SFRN 15SFRN2390002. DNP receives support through the T32 HL007854-22 from the NIH/NHLBI. SJT receives support through the American Heart Association grant SFRN 15SFRN239002. JMS receives support through the HHSN268201300026C grant from the NIH/NHLBI. DLJ receives support through the HHSN268201300026C grant from the NIH/NHLBI. JES receives support through the American Heart Association grant SFRN 15SFRN2390002. CEL receives support through the HHSN268201300026C grant from the NIH/NHLBI and American Heart Association grant SFRN 15SFRN2390002. DS receives support through R01 HL117323 and K24-HL125704 from the NHLBI. PM receives research support American Heart Association grant SFRN 15SFRN2390002

Keywords

ambulatory blood pressure monitoring
hypertension
nocturnal hypertension
non-dipping blood pressure
race and sex

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Internal Medicine
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jch.13474

Cite this

Booth, J. N., Anstey, D. E., Bello, N. A., Jaeger, B. C., Pugliese, D. N., Thomas, S. J., Deng, L., Shikany, J. M., Lloyd-Jones, D., Schwartz, J. E., Lewis, C. E., Shimbo, D., & Muntner, P. (2019). Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Journal of Clinical Hypertension, 21(2), 184-192. https://doi.org/10.1111/jch.13474

@article{466a16685cd54670ab2d858b5dc7937b,

title = "Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study",

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.",

keywords = "ambulatory blood pressure monitoring, hypertension, nocturnal hypertension, non-dipping blood pressure, race and sex",

author = "Booth, {John N.} and Anstey, {D. Edmund} and Bello, {Natalie A.} and Jaeger, {Byron C.} and Pugliese, {Daniel N.} and Thomas, {Stephen Justin} and Luqin Deng and Shikany, {James M.} and Donald Lloyd-Jones and Schwartz, {Joseph E.} and Lewis, {Cora E.} and Daichi Shimbo and Paul Muntner",

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year = "2019",

month = feb,

doi = "10.1111/jch.13474",

language = "English (US)",

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Booth, JN, Anstey, DE, Bello, NA, Jaeger, BC, Pugliese, DN, Thomas, SJ, Deng, L, Shikany, JM, Lloyd-Jones, D, Schwartz, JE, Lewis, CE, Shimbo, D & Muntner, P 2019, 'Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study', Journal of Clinical Hypertension, vol. 21, no. 2, pp. 184-192. https://doi.org/10.1111/jch.13474

TY - JOUR

T1 - Race and sex differences in asleep blood pressure

T2 - The Coronary Artery Risk Development in Young Adults (CARDIA) study

AU - Booth, John N.

AU - Anstey, D. Edmund

AU - Bello, Natalie A.

AU - Jaeger, Byron C.

AU - Pugliese, Daniel N.

AU - Thomas, Stephen Justin

AU - Deng, Luqin

AU - Shikany, James M.

AU - Lloyd-Jones, Donald

AU - Schwartz, Joseph E.

AU - Lewis, Cora E.

AU - Shimbo, Daichi

AU - Muntner, Paul

PY - 2019/2

Y1 - 2019/2

N2 - 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.

AB - 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.

KW - ambulatory blood pressure monitoring

KW - hypertension

KW - nocturnal hypertension

KW - non-dipping blood pressure

KW - race and sex

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Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Abstract

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UN SDGs

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