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  • 1
    Online Resource
    Online Resource
    Health Behaviors, Nocturnal Hypertension, and Non-dipping Blood Pressure: The Coronary Artery Risk Development in Young Adults and Jackson Heart Study
    Oxford University Press (OUP) ; 2019
    In:  American Journal of Hypertension Vol. 32, No. 8 ( 2019-07-17), p. 759-768
    Details
    In: American Journal of Hypertension, Oxford University Press (OUP), Vol. 32, No. 8 ( 2019-07-17), p. 759-768
    Abstract: Several health behaviors have been associated with hypertension based on clinic blood pressure (BP). Data on the association of health behaviors with nocturnal hypertension and non-dipping systolic BP (SBP) are limited. METHODS We analyzed data for participants with ambulatory BP monitoring at the Year 30 Coronary Artery Risk Development in Young Adults (CARDIA) study exam in 2015–2016 (n = 781) and the baseline Jackson Heart Study (JHS) exam in 2000–2004 (n = 1,046). Health behaviors (i.e., body mass index, physical activity, smoking, and alcohol intake) were categorized as good, fair, and poor and assigned scores of 2, 1, and 0, respectively. A composite health behavior score was calculated as their sum and categorized as very good (score range = 6–8), good (5), fair (4), and poor (0–3). Nocturnal hypertension was defined as mean asleep SBP ≥ 120 mm Hg or mean asleep diastolic BP ≥ 70 mm Hg and non-dipping SBP as & lt; 10% awake-to-asleep decline in SBP. RESULTS Among CARDIA study and JHS participants, 41.1% and 56.9% had nocturnal hypertension, respectively, and 32.4% and 72.8% had non-dipping SBP, respectively. The multivariable-adjusted prevalence ratios (95% confidence interval) for nocturnal hypertension associated with good, fair, and poor vs. very good health behavior scores were 1.03 (0.82–1.29), 0.98 (0.79–1.22), and 0.96 (0.77–1.20), respectively in CARDIA study and 0.98 (0.87–1.10), 0.96 (0.86–1.09), and 0.86 (0.74–1.00), respectively in JHS. The health behavior score was not associated non-dipping SBP in CARDIA study or JHS after multivariable adjustment. CONCLUSIONS A health behavior score was not associated with nocturnal hypertension or non-dipping SBP.
    Type of Medium: Online Resource
    ISSN: 0895-7061 , 1941-7225
    URL: Article
    DOI: 10.1093/ajh/hpz017
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
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  • 2
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    Online Resource
    Using Predicted Atherosclerotic Cardiovascular Disease Risk for Discrimination of Awake or Nocturnal Hypertension
    Oxford University Press (OUP) ; 2020
    In:  American Journal of Hypertension Vol. 33, No. 11 ( 2020-11-03), p. 1011-1020
    Details
    In: American Journal of Hypertension, Oxford University Press (OUP), Vol. 33, No. 11 ( 2020-11-03), p. 1011-1020
    Abstract: Several atherosclerotic cardiovascular disease (ASCVD) risk factors are associated with awake and nocturnal hypertension. METHODS We assessed the association between a composite ASCVD risk score and awake or nocturnal hypertension using data from participants aged 40–79 years who completed ambulatory blood pressure monitoring at the Year 30 Coronary Artery Risk Development in Young Adults study exam in 2015–2016 (n = 716) and the baseline Jackson Heart Study exam in 2000–2004 (n = 770). Ten-year predicted ASCVD risk was calculated using the Pooled Cohort risk equations. Awake hypertension was defined as mean awake systolic blood pressure (SBP) ≥135 mm Hg or diastolic blood pressure (DBP) ≥85 mm Hg and nocturnal hypertension was defined as mean asleep SBP ≥120 mm Hg or DBP ≥70 mm Hg. RESULTS Among participants with a 10-year predicted ASCVD risk & lt;5%, 5% to & lt;7.5%, 7.5% to & lt;10%, and ≥10%, the prevalence of awake or nocturnal hypertension as a composite outcome was 29.5%, 47.8%, 62.2%, and 69.7%, respectively. After multivariable adjustment, higher ASCVD risk was associated with higher prevalence ratios for awake or nocturnal hypertension among participants with clinic-measured SBP/DBP & lt;130/85 mm Hg but not ≥130/85 mm Hg. The C-statistic for discriminating between participants with vs. without awake or nocturnal hypertension was 0.012 (95% confidence interval 0.003, 0.016) higher when comparing a model with ASCVD risk and clinic-measured blood pressure (BP) together vs. clinic-measured BP without ASCVD risk. CONCLUSIONS Using 10-year predicted ASCVD risk in conjunction with clinic BP improves discrimination between individuals with and without awake or nocturnal hypertension.
    Type of Medium: Online Resource
    ISSN: 0895-7061 , 1941-7225
    URL: Article
    DOI: 10.1093/ajh/hpaa099
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 3
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    Online Resource
    Abstract P173: The Impact of Asleep Blood Pressure on the Prevalence of Masked Hypertension by Race/ethnicity: Analysis of Pooled Population- and Community-based Studies
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 141, No. Suppl_1 ( 2020-03-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 141, No. Suppl_1 ( 2020-03-03)
    Abstract: Introduction: Masked hypertension is defined as having hypertensive blood pressure (BP) outside of the office setting among adults with non-hypertensive BP when measured in the office. Some guidelines recommend defining out-of-office BP using awake measurements while other guidelines recommend using awake and asleep measurements. Hypothesis: We hypothesized that defining masked hypertension using the awake and asleep BP measurements would increase the prevalence of masked hypertension compared to using the awake period alone, and the magnitude of this difference would be greater among non-Hispanic blacks compared with non-Hispanic whites and Hispanics. Methods: We pooled previously collected data from 5 NHLBI-funded population- and community-based studies including the Jackson Heart Study, the Coronary Artery Risk Development in Young Adults Study (total participants: 2,866). All participants had office systolic BP (SBP) 〈 140mmHg and diastolic BP (DBP) 〈 90mmHg and underwent ambulatory BP monitoring (ABPM) for 24 hours. Hypertensive awake BP was defined as SBP ≥135mmHg or DBP ≥85mmHg while awake, hypertensive asleep BP as SBP ≥120mmHg or DBP ≥70mmHg while asleep and hypertensive 24-hour BP as SBP ≥130mmHg or DBP ≥80mmHg over the entire ABPM period. Results: The prevalence of masked hypertension increased from 29% to 43% when defined using awake, asleep, or 24-hour BP versus using awake BP alone (Table). This increase was larger in non-Hispanic blacks (31-54%) compared with non-Hispanic whites (28-37%) and Hispanics (17-26%). The adjusted prevalence ratio (95% confidence interval) for having masked hypertension for non-Hispanic blacks compared with Non-Hispanic whites was higher from 1.20(1.05,1.37) to 1.33(1.20,1.47) when defined using awake, asleep and 24-hour BP versus awake BP only. Conclusions: Including asleep BP to define masked hypertension increased the prevalence of masked hypertension to a larger extent among non-Hispanic blacks compared to non-Hispanic whites and Hispanics.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.141.suppl_1.P173
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 4
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    Online Resource
    Abstract P117: Association Of Ambulatory Blood Pressure Monitoring Parameters With Left Ventricular Hypertrophy: Analysis Of Pooled Population- And Community-based Studies
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 145, No. Suppl_1 ( 2022-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Objectives: Ambulatory blood pressure (BP) monitoring (ABPM) parameters beyond mean BP may be useful for identifying individuals at high risk for cardiovascular end-organ damage. We examined the association between ABPM parameters, including 24-hour BP load, peak BP, peak increase in BP, and mean BP with left ventricular hypertrophy (LVH). Methods: Data were pooled from five US-based studies in which participants underwent ABPM for 24 hours (n=2,892). We defined systolic BP (SBP) load as the weighted average of the percent awake SBP readings ≥ 130 mm Hg and asleep SBP readings ≥ 110 mm Hg; peak SBP as the weighted average of awake and asleep 90 th percentile of SBP; peak increase as the difference between the peak SBP and mean SBP. These parameters were then categorized into quartiles. LVH was assessed by 2D-echocardiography. Analyses were stratified by mean 24-hour BP 〈 130/80 and ≥ 130/80 mm Hg. Results: Among participants with mean 24-hour BP 〈 130/80 mm Hg, the prevalence of LVH increased from the lowest to the highest quartile for SBP load, peak SBP, peak increase in SBP, and mean SBP ( Table ). The adjusted prevalence ratio (PR) for the association of the highest versus the lowest quartile with LVH was 1.82 (95%CI: 1.08-3.05) for SBP load, 2.00 (95%CI: 1.18-3.38) for peak SBP, 1.38 (95%CI: 0.85-2.23) for peak increase in SBP, and 1.51 (95%CI: 0.98-2.32) for mean SBP. Among participants with mean 24-hour BP ≥ 130/80 mm Hg, the prevalence of LVH increased for all ABPM parameters from the lowest to the highest quartile. The multivariable-adjusted PR for the association of the highest versus the lowest quartile with LVH was 1.39 (95%CI: 0.98-1.97) for SBP load, 1.66 (95%CI: 1.09-2.53) for peak SBP, 1.08 (95%CI: 0.76-1.53) for peak increase in SBP, and 1.88 (95%CI: 1.24-2.83) for mean SBP. Conclusion: The 24-hour SBP load and peak SBP were associated with a higher prevalence of LVH when mean 24-hour BP was 〈 130/80 mm Hg. The 24-hour peak SBP and mean SBP were associated with a higher prevalence of LVH when mean 24-hour BP was ≥ 130/80 mm Hg.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.145.suppl_1.P117
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 5
    Online Resource
    Online Resource
    Impact of Asleep and 24-Hour Blood Pressure Data on the Prevalence of Masked Hypertension by Race/Ethnicity
    Oxford University Press (OUP) ; 2022
    In:  American Journal of Hypertension Vol. 35, No. 7 ( 2022-07-01), p. 627-637
    Details
    In: American Journal of Hypertension, Oxford University Press (OUP), Vol. 35, No. 7 ( 2022-07-01), p. 627-637
    Abstract: We pooled ambulatory blood pressure monitoring data from 5 US studies, including the Jackson Heart Study (JHS), the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Masked Hypertension Study, the Improving the Detection of Hypertension Study, and the North Carolina Masked Hypertension Study. Using a cross-sectional study design, we estimated differences in the prevalence of masked hypertension by race/ethnicity when out-of-office blood pressure (BP) included awake, asleep, and 24-hour BP vs. awake BP alone. METHODS We restricted the analyses to participants with office systolic BP (SBP) & lt;130 mm Hg and diastolic BP (DBP) & lt;80 mm Hg. High awake BP was defined as mean SBP/DBP ≥130/80 mm Hg, high asleep BP as mean SBP/DBP ≥110/65 mm Hg, and high 24-hour BP as mean SBP/DBP ≥125/75 mm Hg. RESULTS Among participants not taking antihypertensive medication (n = 1,292), the prevalence of masked hypertension with out-of-office BP defined by awake BP alone or by awake, asleep, or 24-hour BP was 34.5% and 48.7%, respectively, among non-Hispanic White, 39.7% and 67.6% among non-Hispanic Black, and 19.4% and 35.1% among Hispanic participants. After multivariable adjustment, non-Hispanic Black were more likely than non-Hispanic White participants to have masked hypertension by asleep or 24-hour BP but not awake BP (adjusted odds ratio [OR] 2.14 95% confidence interval [CI] 1.45–3.15) and by asleep or 24-hour BP and awake BP (OR 1.61; 95% CI 1.12–2.32) vs. not having masked hypertension. CONCLUSIONS Assessing asleep and 24-hour BP measures increases the prevalence of masked hypertension more among non-Hispanic Black vs. non-Hispanic White individuals.
    Type of Medium: Online Resource
    ISSN: 0895-7061 , 1941-7225
    URL: Article
    DOI: 10.1093/ajh/hpac027
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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