Twenty-four-hour versus clinic blood pressure levels as predictors of long-term cardiovascular and renal disease outcomes among African Americans. Sci Rep 2020 Jul 15;10(1):11685
Date
07/17/2020Pubmed ID
32669581Pubmed Central ID
PMC7363933DOI
10.1038/s41598-020-68466-5Scopus ID
2-s2.0-85087974638 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
In Caucasian and Asian populations, evidence suggests that 24-h blood pressures (BP) are more predictive of long-term cardiovascular events than clinic BP. However, few long-term studies have evaluated the predictive value of 24-h BP phenotypes (24-h, daytime, nighttime) among African Americans (AA). The purpose of this study is to evaluate the added value of 24-h BP phenotypes compared to clinic BP in predicting the subsequent fatal and non-fatal cardiovascular/renal disease events in AA subjects. AA subjects (n = 270) were initially studied between 1994 and 2006 and standardized clinic BP measurements were obtained during screening procedures for a 3-day inpatient clinical study during which 24-h BP measurements were obtained. To assess the subsequent incidence of cardiovascular and renal disease events, follow-up information was obtained and confirmed by review of paper and electronic medical records between 2015 and 2017. During a mean follow-up of 14 ± 4 years, 50 subjects had one or more fatal or non-fatal cardiovascular/renal disease events. After adjustment for covariates, clinic systolic and diastolic BP were strongly associated with cardiovascular/renal disease events and all-cause mortality (p < 0.0001). Twenty-four-hour BP phenotypes conferred a small incremental advantage over clinic BP in predicting cardiovascular/renal events, which was limited to making a difference of one predicted event in 250-1,000 predictions depending on the 24-h BP phenotype. Nocturnal BP was no more predictive than the other 24-h BP phenotypes. In AA, 24-h BP monitoring provides limited added value as a predictor of cardiovascular/renal disease events. Larger studies are needed in AA to confirm these findings.
Author List
Kidambi S, Wang T, Chelius T, Nunuk I, Agarwal P, Laud P, Mattson D, Cowley AW Jr, Liang M, Kotchen TAuthors
Thomas H. Chelius Biostatistician I in the Institute for Health and Equity department at Medical College of WisconsinAllen W. Cowley Jr PhD Professor in the Physiology department at Medical College of Wisconsin
Srividya Kidambi MD Sr Medical Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Tao Wang PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Area Under Curve
Biomarkers
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Cardiovascular System
Female
Heart Failure
Humans
Hypertension
Kidney
Longitudinal Studies
Male
Middle Aged
Phenotype
Prognosis
ROC Curve
Renal Insufficiency
Risk Factors
Survival Analysis
