Race differences in ambulatory blood pressure monitoring parameters

Swati Sakhuja; Byron C. Jaeger; Yuichiro Yano; Daichi Shimbo; Cora E. Lewis; Donald Clark; Gabriel S. Tajeu; Shakia T. Hardy; Norrina B. Allen; James M. Shikany; Joseph E. Schwartz; Anthony J. Viera; Paul Muntner

doi:10.1097/MBP.0000000000000680

Race differences in ambulatory blood pressure monitoring parameters

Swati Sakhuja^*, Byron C. Jaeger, Yuichiro Yano, Daichi Shimbo, Cora E. Lewis, Donald Clark, Gabriel S. Tajeu, Shakia T. Hardy, Norrina B. Allen, James M. Shikany, Joseph E. Schwartz, Anthony J. Viera, Paul Muntner

^*Corresponding author for this work

Preventive Medicine

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

Abstract

Background Mean systolic and diastolic blood pressure (SBP and DBP) on ambulatory blood pressure (BP) monitoring (ABPM) are higher among Black compared with White adults. With 48 to 72 BP measurements obtained over 24 h, ABPM can generate parameters other than mean BP that are associated with increased risk for cardiovascular events. There are few data on race differences in ABPM parameters other than mean BP. Methods: To estimate differences between White and Black participants in ABPM parameters, we used pooled data from five US-based studies in which participants completed ABPM (n = 2580). We calculated measures of SBP and DBP level, including mean, load, peak, and measures of SBP and DBP variability, including average real variability (ARV) and peak increase. Results: There were 1513 (58.6%) Black and 1067 (41.4%) White participants with mean ages of 56.1 and 49.0 years, respectively. After multivariable adjustment, asleep SBP and DBP load were 5.7% (95% CI: 3.5-7.9%) and 2.7% (95% CI: 1.1-4.3%) higher, respectively, among Black compared with White participants. Black compared with White participants also had higher awake DBP ARV (0.3 [95%CI: 0.0-0.6] mmHg) and peak increase in DBP (0.4 [95% CI: 0.0-0.8] mmHg). There was no evidence of Black: White differences in awake measures of SBP level, asleep peak SBP or DBP, awake and asleep measures of SBP variability or asleep measures of DBP variability after multivariable adjustment. Conclusion: Asleep SBP load, awake DBP ARV and peak increase in awake DBP were higher in Black compared to White participants, independent of mean BP on ABPM.

Original language	English (US)
Pages (from-to)	23-30
Number of pages	8
Journal	Blood Pressure Monitoring
Volume	29
Issue number	1
DOIs	https://doi.org/10.1097/MBP.0000000000000680
State	Published - Feb 1 2024

Funding

We would like to thank the staff and participants of the JHS, CARDIA, IDH, MHT and NCMH studies. The CARDIA study is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). The JHS is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I) and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the NHLBI and the National Institute on Minority Health and Health Disparities. This study is also supported by R01HL144773-03 and P01HL47540 from the NHLBI. The NCMH study was funded by R01 HL098604-01 from the NHLBI of the National Institutes of Health. GST and STH also received funding from 1K01HL151974-0 and K01HL164763, respectively, from NHLBI. The CARDIA study is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute (NHLBI). The JHS is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I) and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the NHLBI and the National Institute on Minority Health and Health Disparities. This study is also supported by R01HL144773-03 and P01HL47540 from the NHLBI. The NCMH study was funded by R01 HL098604-01 from the NHLBI of the National Institutes of Health. GST and STH also received funding from 1K01HL151974-0 and K01HL164763, respectively, from NHLBI.

Keywords

ambulatory blood pressure monitoring
blood pressure load
blood pressure variability
peak blood pressure
peak increase in blood pressure
race differences

ASJC Scopus subject areas

Internal Medicine
Cardiology and Cardiovascular Medicine
Assessment and Diagnosis
Advanced and Specialized Nursing

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10.1097/MBP.0000000000000680

Cite this

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title = "Race differences in ambulatory blood pressure monitoring parameters",

abstract = "Background Mean systolic and diastolic blood pressure (SBP and DBP) on ambulatory blood pressure (BP) monitoring (ABPM) are higher among Black compared with White adults. With 48 to 72 BP measurements obtained over 24 h, ABPM can generate parameters other than mean BP that are associated with increased risk for cardiovascular events. There are few data on race differences in ABPM parameters other than mean BP. Methods: To estimate differences between White and Black participants in ABPM parameters, we used pooled data from five US-based studies in which participants completed ABPM (n = 2580). We calculated measures of SBP and DBP level, including mean, load, peak, and measures of SBP and DBP variability, including average real variability (ARV) and peak increase. Results: There were 1513 (58.6%) Black and 1067 (41.4%) White participants with mean ages of 56.1 and 49.0 years, respectively. After multivariable adjustment, asleep SBP and DBP load were 5.7% (95% CI: 3.5-7.9%) and 2.7% (95% CI: 1.1-4.3%) higher, respectively, among Black compared with White participants. Black compared with White participants also had higher awake DBP ARV (0.3 [95%CI: 0.0-0.6] mmHg) and peak increase in DBP (0.4 [95% CI: 0.0-0.8] mmHg). There was no evidence of Black: White differences in awake measures of SBP level, asleep peak SBP or DBP, awake and asleep measures of SBP variability or asleep measures of DBP variability after multivariable adjustment. Conclusion: Asleep SBP load, awake DBP ARV and peak increase in awake DBP were higher in Black compared to White participants, independent of mean BP on ABPM.",

keywords = "ambulatory blood pressure monitoring, blood pressure load, blood pressure variability, peak blood pressure, peak increase in blood pressure, race differences",

author = "Swati Sakhuja and Jaeger, {Byron C.} and Yuichiro Yano and Daichi Shimbo and Lewis, {Cora E.} and Donald Clark and Tajeu, {Gabriel S.} and Hardy, {Shakia T.} and Allen, {Norrina B.} and Shikany, {James M.} and Schwartz, {Joseph E.} and Viera, {Anthony J.} and Paul Muntner",

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month = feb,

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doi = "10.1097/MBP.0000000000000680",

language = "English (US)",

volume = "29",

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journal = "Blood Pressure Monitoring",

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TY - JOUR

T1 - Race differences in ambulatory blood pressure monitoring parameters

AU - Sakhuja, Swati

AU - Jaeger, Byron C.

AU - Yano, Yuichiro

AU - Shimbo, Daichi

AU - Lewis, Cora E.

AU - Clark, Donald

AU - Tajeu, Gabriel S.

AU - Hardy, Shakia T.

AU - Allen, Norrina B.

AU - Shikany, James M.

AU - Schwartz, Joseph E.

AU - Viera, Anthony J.

AU - Muntner, Paul

PY - 2024/2/1

Y1 - 2024/2/1

N2 - Background Mean systolic and diastolic blood pressure (SBP and DBP) on ambulatory blood pressure (BP) monitoring (ABPM) are higher among Black compared with White adults. With 48 to 72 BP measurements obtained over 24 h, ABPM can generate parameters other than mean BP that are associated with increased risk for cardiovascular events. There are few data on race differences in ABPM parameters other than mean BP. Methods: To estimate differences between White and Black participants in ABPM parameters, we used pooled data from five US-based studies in which participants completed ABPM (n = 2580). We calculated measures of SBP and DBP level, including mean, load, peak, and measures of SBP and DBP variability, including average real variability (ARV) and peak increase. Results: There were 1513 (58.6%) Black and 1067 (41.4%) White participants with mean ages of 56.1 and 49.0 years, respectively. After multivariable adjustment, asleep SBP and DBP load were 5.7% (95% CI: 3.5-7.9%) and 2.7% (95% CI: 1.1-4.3%) higher, respectively, among Black compared with White participants. Black compared with White participants also had higher awake DBP ARV (0.3 [95%CI: 0.0-0.6] mmHg) and peak increase in DBP (0.4 [95% CI: 0.0-0.8] mmHg). There was no evidence of Black: White differences in awake measures of SBP level, asleep peak SBP or DBP, awake and asleep measures of SBP variability or asleep measures of DBP variability after multivariable adjustment. Conclusion: Asleep SBP load, awake DBP ARV and peak increase in awake DBP were higher in Black compared to White participants, independent of mean BP on ABPM.

AB - Background Mean systolic and diastolic blood pressure (SBP and DBP) on ambulatory blood pressure (BP) monitoring (ABPM) are higher among Black compared with White adults. With 48 to 72 BP measurements obtained over 24 h, ABPM can generate parameters other than mean BP that are associated with increased risk for cardiovascular events. There are few data on race differences in ABPM parameters other than mean BP. Methods: To estimate differences between White and Black participants in ABPM parameters, we used pooled data from five US-based studies in which participants completed ABPM (n = 2580). We calculated measures of SBP and DBP level, including mean, load, peak, and measures of SBP and DBP variability, including average real variability (ARV) and peak increase. Results: There were 1513 (58.6%) Black and 1067 (41.4%) White participants with mean ages of 56.1 and 49.0 years, respectively. After multivariable adjustment, asleep SBP and DBP load were 5.7% (95% CI: 3.5-7.9%) and 2.7% (95% CI: 1.1-4.3%) higher, respectively, among Black compared with White participants. Black compared with White participants also had higher awake DBP ARV (0.3 [95%CI: 0.0-0.6] mmHg) and peak increase in DBP (0.4 [95% CI: 0.0-0.8] mmHg). There was no evidence of Black: White differences in awake measures of SBP level, asleep peak SBP or DBP, awake and asleep measures of SBP variability or asleep measures of DBP variability after multivariable adjustment. Conclusion: Asleep SBP load, awake DBP ARV and peak increase in awake DBP were higher in Black compared to White participants, independent of mean BP on ABPM.

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KW - blood pressure variability

KW - peak blood pressure

KW - peak increase in blood pressure

KW - race differences

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Race differences in ambulatory blood pressure monitoring parameters

Abstract

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Keywords

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