Blood Pressure Dipping and Urban Stressors in Young Adult African Americans

Mellman, Thomas A.; Brown, Tyish S. Hall; Kobayashi, Ihori; Abu-Bader, Soleman H.; Lavela, Joseph; Altaee, Duaa; McLaughlin, Latesha; Randall, Otelio S.

doi:10.1007/s12160-014-9684-x

Cited by 17 publications

(19 citation statements)

References 20 publications

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“…mares, insomnia) in PTSD (81,90). In particular, blunted day-tonight reduction (8,72,73) and elevation of nocturnal SNS arousal or SNS dominance over parasympathetic nervous system (PNS) function have been observed in PTSD (77,115). Moreover, young adult African-Americans with PTSD had a lower PNS activation indexed by heart rate variability during sleep at home compared with those who were resilient to trauma (i.e., individuals who had never experienced significant PTSD symptoms despite exposure to a high-impact trauma) (54).…”

Section: Autonomic Dysfunction In Ptsdmentioning

confidence: 99%

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Brudey

Park

Wiaderkiewicz

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

Self Cite

106

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-Stressand anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated longterm comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed. posttraumatic stress disorder; cardiovascular disease; renin-angiotensin system POSTTRAUMATIC STRESS DISORDER (PTSD) is a psychiatric illness characterized by persistent emotional and mental stress following a traumatic event. Symptoms of PTSD include hyperarousal, flashbacks, intrusive thoughts, or nightmares, and avoidance of activities that trigger memories of the traumatic event. The health consequences of PTSD are substantial, affecting multiple organ systems, with evidence linking PTSD to diseases such as cancer, arthritis, digestive disease, and cardiovascular disease (CVD) (13,14,112). The evidence demonstrating increased risk for CVD in PTSD (9,15,19,49,57,58) is compelling, and several excellent recent review articles have highlighted this association (20,23,52,63,112). While this association could certainly be due, in part, to related unhealthy behaviors, such as increased prevalence of smoking, poor diet, and physical inactivity (46,119). Yet even after adjustments for lifestyle, comorbid conditions, and combat engagements in multivariate models, PTSD remains a significant and independent risk factor for the development of CVD and CVD-related mortality (15).Increased CVD risk in PTSD has been demonstrated in both military (21) and civilian populations (44,82). A co-twin study design (monozygotic and dizygotic), which controlled for genetic and familial confounders, demonstrated that the incidence of coronary heart disease was more than double in Vietnam War veteran twins with PTSD (22.6%) compared with those without PTSD (8.9%) (106). Most recently, one of the largest longitudinal studies examining the association between PTSD and heart failure was completed, and veterans with PTSD were shown to be nearly 50% more likely to develop heart failure than veterans without PTSD (91). This remained significant after adjustments for age, sex, diabetes, hyperlipidemia, hypertension, body mass index, combat, and military service. Civilian PTSD populations are also at greater risk for CVD. Following life-threatening traumatic events such as earthquakes (82), the 9 -11 World Trade Center attack (45), and living in urban dis...

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Section: Autonomic Dysfunction In Ptsdmentioning

confidence: 99%

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Brudey

Park

Wiaderkiewicz

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

Self Cite

106

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“…These studies 17,18 were not populationbased, included mostly individuals who had untreated hypertension, and did not include blacks. Several studies [31][32][33][34][35][36] have examined BP dipping in blacks or Caribbean blacks. These studies were typically small, 31,34 were not populationbased, [31][32][33][34]36 did not examine reverse dipping [31][32][33][34] or LVMI, [31][32][33] and did not consider antihypertensive medication use.…”

Section: Discussionmentioning

confidence: 99%

Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study

Abdalla

Caughey

Tanner

et al. 2017

JAHA

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BackgroundAbnormal diurnal blood pressure (BP), including nondipping patterns, assessed using ambulatory BP monitoring, have been associated with increased cardiovascular risk among white and Asian adults. We examined the associations of BP dipping patterns (dipping, nondipping, and reverse dipping) with cardiovascular target organ damage (left ventricular mass index and left ventricular hypertrophy), among participants from the Jackson Heart Study, an exclusively black population–based cohort.Methods and ResultsAnalyses included 1015 participants who completed ambulatory BP monitoring and had echocardiography data from the baseline visit. Participants were categorized based on the nighttime to daytime systolic BP ratio into 3 patterns: dipping pattern (≤0.90), nondipping pattern (>0.90 to ≤1.00), and reverse dipping pattern (>1.00). The prevalence of dipping, nondipping, and reverse dipping patterns was 33.6%, 48.2%, and 18.2%, respectively. In a fully adjusted model, which included antihypertensive medication use and clinic and daytime systolic BP, the mean differences in left ventricular mass index between reverse dipping pattern versus dipping pattern was 8.3±2.1 g/m2 (P<0.001) and between nondipping pattern versus dipping pattern was −1.0±1.6 g/m2 (P=0.536). Compared with participants with a dipping pattern, the prevalence ratio for having left ventricular hypertrophy was 1.65 (95% CI, 1.05–2.58) and 0.96 (95% CI, 0.63–1.97) for those with a reverse dipping pattern and nondipping pattern, respectively.ConclusionsIn this population‐based study of blacks, a reverse dipping pattern was associated with increased left ventricular mass index and a higher prevalence of left ventricular hypertrophy. Identification of a reverse dipping pattern on ambulatory BP monitoring may help identify black at increased risk for cardiovascular target organ damage.

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“…For full inclusion/exclusion criteria, including unusual sleep–wake schedules or night shift work, and recruitment and screening procedures see Mellman et al . (). All evaluations took place in the Clinical Research Unit of Howard University Hospital.…”

Section: Methodsmentioning

confidence: 97%

“…Poor sleepers had at least one of the following: an ISI score greater than 15 [indicating severe insomnia (Morin et al ., )], average hours of sleep per night fewer than 6 or sleep efficiency below 85%. Ninety‐two of 145 participants from a previous study of sleep and nocturnal blood pressure (Mellman et al ., ) met those criteria (43: ‘good’ sleepers, 49: ‘poor’ sleepers) and of those, 40 provided blood samples. An additional 64 participants, 35 of whom met all criteria and provided blood samples, were recruited subsequently to increase the sample size.…”

Section: Methodsmentioning

confidence: 99%

Period 3 gene polymorphism and sleep adaptation to stressful urban environments

Anderson

Akeeb

Lavela

et al. 2016

Journal of Sleep Research

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Summary This study's objective was to investigate the relationship between a variable‐number tandem‐repeat (VNTR) Period 3 gene (PER3) polymorphism and sleep adaptation to stressful urban environments. Seventy‐five (49 female) African American participants (ages 18–35 years) living in neighbourhoods with high rates of violent crime were selected for the study based on converging criteria for good or poor sleep. Categorization of sleep quality was based on the Insomnia Severity Index (ISI), estimates of typical sleep duration and sleep efficiency. Other assessments included the Fear of Sleep Index (FOSI) and City Stress Inventory (CSI). Whole blood DNA was analysed for the 4 and 5 VNTR alleles using polymerase chain reaction (PCR) and restrictive enzyme digestion. Fifty‐seven per cent of those who were homo‐ or heterozygous for the 4‐repeat allele were poor sleepers versus 25% of those homozygous for the 5‐repeat allele; χ2 = 4.17, P = 0.041. In a logistic regression model with all the variables with significant bivariate relationships to sleep quality group, FOSI was the only significant predictor (χ2 = 5.68, P = 0.017). FOSI scores were higher among those with the 4‐repeat allele (t = 2.66, P = 0.013). The PER3 4 and 5 VNTR polymorphisms appear to influence sensitivity to the effects of stressful urban environments on sleep. While FOSI was the only variable associated independently with sleep quality category, the candidate vulnerability allele was also associated with greater ‘fear of sleep’.

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Blood Pressure Dipping and Urban Stressors in Young Adult African Americans

Cited by 17 publications

References 20 publications

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease

Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study

Period 3 gene polymorphism and sleep adaptation to stressful urban environments

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