Clinic and ambulatory blood pressure in a population-based sample of African Americans

The Jackson Heart Study

S. Justin Thomas, John N. Booth, Samantha G. Bromfield, Samantha R. Seals, Tanya M. Spruill, Gbenga Ogedegbe, Srividya Kidambi, Daichi Shimbo, David Calhoun, Paul Muntner

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalJournal of the American Society of Hypertension
DOIs
StateAccepted/In press - Nov 15 2016

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African Americans
Blood Pressure
Antihypertensive Agents
Population
Ambulatory Blood Pressure Monitoring
Hypertension
Masked Hypertension
White Coat Hypertension
Diagnostic Errors
Phenotype

Keywords

  • Ambulatory blood pressure monitoring
  • Masked hypertension
  • Nocturnal hypertension
  • Nondipping

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Clinic and ambulatory blood pressure in a population-based sample of African Americans : The Jackson Heart Study. / Thomas, S. Justin; Booth, John N.; Bromfield, Samantha G.; Seals, Samantha R.; Spruill, Tanya M.; Ogedegbe, Gbenga; Kidambi, Srividya; Shimbo, Daichi; Calhoun, David; Muntner, Paul.

In: Journal of the American Society of Hypertension, 15.11.2016.

Research output: Contribution to journalArticle

Thomas, S. Justin ; Booth, John N. ; Bromfield, Samantha G. ; Seals, Samantha R. ; Spruill, Tanya M. ; Ogedegbe, Gbenga ; Kidambi, Srividya ; Shimbo, Daichi ; Calhoun, David ; Muntner, Paul. / Clinic and ambulatory blood pressure in a population-based sample of African Americans : The Jackson Heart Study. In: Journal of the American Society of Hypertension. 2016.
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abstract = "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.",
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