Socioeconomic Status, Psychosocial Factors, Race and Nocturnal Blood Pressure Dipping in a Hispanic Cohort

Rodríguez, Carlos J.; Jin, Zhezhen; Schwartz, Joseph E.; Turner-Lloveras, Daniel; Sacco, Ralph L.; Tullio, Marco R. Di; Homma, Shunichi

doi:10.1093/ajh/hpt009

Cited by 15 publications

(12 citation statements)

References 46 publications

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“…Thus inconsistent findings may in part result from different indicators of socioeconomic status. Regarding BMI, it is unclear why some studies found a link to BP dipping (e.g., Cuspidi et al, 2008; Stepnowsky et al, 2004), while our and other data did not indicate this association (e.g., Loredo, Ancoli-Israel, & Dimsdale, 2001; Rodriguez et al, 2013), and further research is necessary to clarify this issue.…”

Section: Discussioncontrasting

confidence: 73%

Neighborhood problems and nocturnal blood pressure dipping.

et al. 2014

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Objective Living in adverse neighborhood conditions has been linked with greater prevalence of cardiovascular disease (CVD). We aimed to learn whether perceived neighborhood problems are related to attenuated nocturnal blood pressure (BP) dipping, a risk factor for CVD morbidity. Method A sample of 133 adults (71 male, 62 female; 80 White, 53 Black) underwent 24-hr ambulatory blood pressure monitoring. The neighborhood problem scale (NPS) was used to assess neighborhood environmental stressors. Results Nocturnal dipping in systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure was reduced in individuals with higher NPS scores (p < .05). Hierarchical regression analyses revealed that neighborhood problems explained 4%–6% of the variance in SBP, DBP, and MAP dipping (p < .05) even after adjusting for several theoretical confounders such as social status, age, gender, race, body mass index (BMI), smoking, exercise, depression and discrimination. Conclusion Neighborhood problems may contribute to attenuated BP dipping beyond the effect of known risk factors.

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Section: Discussioncontrasting

confidence: 73%

Neighborhood problems and nocturnal blood pressure dipping.

et al. 2014

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“…30 Epidemiologically, salt sensitivity is more common in the Black population and this might explain the racial differences observed in non-dipping blood pressure profiles. [15][16][17][18][30][31][32][33] Our crosssectional study demonstrates that a non-dipping 24 hour ABP profile in normotensive healthy Blacks is associated with evidence of cardiac damage evidenced by the changes in cardiac geometry as described. The higher, sustained blood pressures at night may have had a cumulative effect on cardiac structure over time.…”

Section: Discussionsupporting

confidence: 49%

“…14 Several studies have demonstrated that NDP is more common in Black hypertensives compared with other races. [15][16][17][18] Cardiovascular mortality and morbidity is also more pronounced in the Black population, [19][20][21] with many attributing this disparity mainly to increased risk factors like obesity, diet, poor access to health care and other socioeconomic determinants of health. [22][23][24][25][26] Purpose: A non-dipping pattern of nocturnal blood pressure in hypertensive patients is an established predictor of cardiovascular risk, especially in Blacks.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal Non-dipping Blood Pressure Profile in Black Normotensives Is Associated with Cardiac Target Organ Damage

Mezue

Isiguzo²,

Madu

et al. 2016

Ethn Dis

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Purpose: A non-dipping pattern of nocturnal blood pressure in hypertensive patients is an established predictor of cardiovascular risk, especially in Blacks. However, data on non-dipping normotensives and cardiovascular risk in this population is sparse. In this study, we aim to determine if a non-dipping profile in a cohort of Black normotensives is associated with cardiac target organ damage. Methods: We studied ambulatory blood pressure patterns in 43 normotensive Black patients of Caribbean origin and classified their profiles as dippers (DP) and nondippers (NDP) based on their nocturnal blood pressure profiles. Cardiac target organ damage was estimated from 2-D echocardiogram. Results: The mean age of the cohort was 52 years. Both groups were similar with respect to baseline age, sex, weight, height, body mass index and daytime ambulatory BP. There was a statistically significant difference in nocturnal blood pressure between DP and NDP groups (112 ± 7/64 ± 2 mm Hg vs 117 ± 3/69 ± 2 mm Hg, P=.004). The NDP cohort showed evidence of cardiovascular target damage on echocardiography with a significantly increased relative wall thickness (.35 ± .07cm vs .42 ± .05 cm, P=.001), left ventricular mass index (95 ± 14 vs 105 ± 14 g/m2, P=.018) and left atrial volume index (26 ± 3.5 vs. 30 ± 3.4, P=.001). Left ventricular geometry in the non-dippers also showed increased concentric remodeling, concentric and eccentric hypertrophy. Conclusions: Our study demonstrates that nocturnal non-dipping of blood pressure in normotensive Blacks of Caribbean origin may be associated with cardiovascular end organ damage thereby providing new surveillance and therapeutic targets. Ethn Dis.2016;26(3):279-284; doi:10.18865/ed.26.3.279

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“…12 We have previously shown that Hispanic black and Hispanic whites may have more similarities in regards to ABP non-dipping to their non-Hispanic counterparts. 59 Our study did not include an evaluation or measure of anger, a common response to discriminatory experiences, at least among non-Hispanic populations. Finally, our study was cross-sectional, which precludes any conclusions about causality.…”

Section: Discussionmentioning

confidence: 99%

Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: The Influence of Social Support and Race

et al. 2016

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Objective Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Methods Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perceived racism, socioeconomic status, social support, and ABP monitoring. Nocturnal ABP non-dipping was defined as a less than 10% decline in the average asleep systolic BP (SBP) relative to the awake SBP. Results Overall, 77.8% of participants reported some form of perceived racism [Perceived Ethnic Discrimination Questionnaire (PEDQ) scores >1.0]. Greater social support was associated with less perceived discrimination (Spearman r =−0.54; p<0.001). Those with higher perceived discrimination scores reported more depressive symptoms (r =0.25; p<0.001). Those with higher PEDQ scores were less likely to show nocturnal ABP non-dipping in multivariate models (OR=0.40, CI=0.17–0.98; p=0.045). Among those with low perceived racism, black Hispanic participants were more likely to have nocturnal ABP non-dipping (82.6%) compared to white Hispanics (53.9%; p=0.02). Among those with high perceived racism, no associations between race and the prevalence of ABP non-dipping was found (black Hispanic=61.5% vs. white Hispanic=51.4%, p=0.39; p interaction=0.89). Conclusions Perceived racism is relatively common among US Hispanics and is associated with ABP. Non-dipping of ABP, a potential cardiovascular risk factor, was more common in black-Hispanic participants with low perceived racism. This finding may reflect different coping mechanisms between black versus white Hispanics and related blood pressure levels during daytime exposures to discrimination.

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Socioeconomic Status, Psychosocial Factors, Race and Nocturnal Blood Pressure Dipping in a Hispanic Cohort

Abstract: These results document a substantial prevalence of nondipping in a cohort of predominantly normotensive Hispanics. Dipping status varied significantly by race. Lower SES is significantly associated with nondipping status, and race potentially impacts on this relation.

Cited by 15 publications

References 46 publications

Neighborhood problems and nocturnal blood pressure dipping.

Neighborhood problems and nocturnal blood pressure dipping.

Nocturnal Non-dipping Blood Pressure Profile in Black Normotensives Is Associated with Cardiac Target Organ Damage

Perceived Discrimination and Nocturnal Blood Pressure Dipping Among Hispanics: The Influence of Social Support and Race

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