Clinic and ambulatory blood pressure in a population-based sample of African Americans: the Jackson Heart Study. J Am Soc Hypertens 2017 Apr;11(4):204-212.e5
Date
03/14/2017Pubmed ID
28285829Pubmed Central ID
PMC5466494DOI
10.1016/j.jash.2017.02.001Scopus ID
2-s2.0-85014781575 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
Blood pressure (BP) can differ substantially when measured in the clinic versus outside of the clinic setting. Few population-based studies with ambulatory blood pressure monitoring (ABPM) include African Americans. We calculated the prevalence of clinic hypertension and ABPM phenotypes among 1016 participants in the population-based Jackson Heart Study, an exclusively African-American cohort. Mean daytime systolic BP was higher than mean clinic systolic BP among participants not taking antihypertensive medication (127.1[standard deviation 12.8] vs. 124.5[15.7] mm Hg, respectively) and taking antihypertensive medication (131.2[13.6] vs. 130.0[15.6] mm Hg, respectively). Mean daytime diastolic BP was higher than clinic diastolic BP among participants not taking antihypertensive medication (78.2[standard deviation 8.9] vs. 74.6[8.4] mm Hg, respectively) and taking antihypertensive medication (77.6[9.4] vs. 74.3[8.5] mm Hg, respectively). The prevalence of daytime hypertension was higher than clinic hypertension for participants not taking antihypertensive medication (31.8% vs. 14.3%) and taking antihypertensive medication (43.0% vs. 23.1%). A high percentage of participants not taking and taking antihypertensive medication had nocturnal hypertension (49.4% and 61.7%, respectively), white-coat hypertension (30.2% and 29.3%, respectively), masked hypertension (25.4% and 34.6%, respectively), and a nondipping BP pattern (62.4% and 69.6%, respectively). In conclusion, these data suggest hypertension may be misdiagnosed among African Americans without using ABPM.
Author List
Thomas SJ, Booth JN 3rd, Bromfield SG, Seals SR, Spruill TM, Ogedegbe G, Kidambi S, Shimbo D, Calhoun D, Muntner PAuthor
Srividya Kidambi MD Sr Medical Director, Chief, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Antihypertensive Agents
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm
Cohort Studies
Diagnostic Errors
Female
Humans
Male
Masked Hypertension
Middle Aged
Prevalence
Risk Assessment
Risk Factors
United States
White Coat Hypertension
